Solid tumors subsequent to arsenic trioxide treatment for acute promyelocytic leukemia

Leuk Res. 2007 Jan;31(1):105-8. doi: 10.1016/j.leukres.2006.03.018. Epub 2006 May 24.

Abstract

Arsenic trioxide (As(2)O(3)) is highly efficacious for acute promyelocytic leukemia (APL). Environmental arsenic exposure predisposes to malignancies, but the risk for therapeutic arsenic is undefined. Three APL patients (de novo, 2; therapy-related, 1) in a cohort of 59 cases given oral-As(2)O(3) for induction and maintenance treatment developed secondary cancers (nasopharyngeal carcinoma, 2; colonic adenocarcinoma, 1) at 16, 36 and 55 months post-As(2)O(3) therapy. Retrospective analysis of biomarkers (Epstein Barr virus serology and quantification, carcinoembryonic antigen) showed the potential presence of cancers before or shortly after As(2)O(3) therapy, suggesting that As(2)O(3) had not initiated these malignancies. Compared against matched background population, there was an increased risk of second cancer (p=0.012, standard incidence ratio=6.5; 95% confidence interval=1.4-19.0).

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / chemically induced*
  • Adult
  • Aged
  • Arsenic Trioxide
  • Arsenicals / adverse effects*
  • Arsenicals / therapeutic use*
  • Colonic Neoplasms / chemically induced*
  • Female
  • Growth Inhibitors / adverse effects
  • Growth Inhibitors / therapeutic use
  • Humans
  • Leukemia, Promyelocytic, Acute / drug therapy*
  • Male
  • Nasopharyngeal Neoplasms / chemically induced*
  • Neoplasms / chemically induced*
  • Oxides / adverse effects*
  • Oxides / therapeutic use*

Substances

  • Arsenicals
  • Growth Inhibitors
  • Oxides
  • Arsenic Trioxide