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Arsenic trioxide for acute promyelocytic leukemia in a patient on chronic hemodialysis
Jose Tinajero1, Khaled El-Shami2, Xiaojun Wu2
1Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD, United States.
Abstract:
Acute promyelocytic leukemia (APL) is a rare acute leukemia generally considered curable with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). Some patients have co-morbidities that may limit the use of these agents and therefore impact curability. Adverse effects of ATO include life-threatening electrocardiographic abnormalities. ATO and its metabolites are partially excreted in the urine, and it is unclear to what extent ATO pharmacokinetics are impacted by hemodialysis. We present a patient on chronic hemodialysis successfully treated with ATO and ATRA for newly diagnosed APL. Complete molecular remission was achieved after induction and several drug-related toxicities were managed.
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