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When Poisons Cure: The Case of Arsenic in Acute Promyelocytic Leukemia.
Chemotherapy. 2019; 64(5-6):238-247.C

Abstract

Arsenic has been known for centuries for its double-edged potential: a poison and at the same time a therapeutic agent. The name "arsenikon," meaning "potent," speaks itself for the pharmaceutical properties of this compound, questioned and analyzed for at least 2000 years. In the last decades, acute promyelocytic leukemia (APL) has evolved from a highly fatal to a curable disease, due to the use of all-trans-retinoic acid and, more recently, arsenic trioxide combinations. The success of these entirely chemo-free regimens increased the awareness of APL and reduced the prevalence of early deaths, which was an impending issue in this disease. Further improvements are expected with the next use of oral arsenic formulations, which will allow a complete outpatient approach, at least in the post-induction settings, further improving patients' quality of life. The wide use of standardized approaches in APL will also help unravel long-standing open questions, including the pathogenesis, prevention, and treatment of the differentiation syndrome and of short-term organ toxicities. In the long term, the study of survivorship issues, such as fertility and organ-related and psychological damages, in the increasing number of survivors will help further improve their life after APL.

Authors+Show Affiliations

Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy, voso@med.uniroma2.it. Fondazione Santa Lucia, Laboratorio di Neuro-Oncoematologia, Roma, Italy, voso@med.uniroma2.it.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32521534

Citation

Gurnari, Carmelo, et al. "When Poisons Cure: the Case of Arsenic in Acute Promyelocytic Leukemia." Chemotherapy, vol. 64, no. 5-6, 2019, pp. 238-247.
Gurnari C, De Bellis E, Divona M, et al. When Poisons Cure: The Case of Arsenic in Acute Promyelocytic Leukemia. Chemotherapy. 2019;64(5-6):238-247.
Gurnari, C., De Bellis, E., Divona, M., Ottone, T., Lavorgna, S., & Voso, M. T. (2019). When Poisons Cure: The Case of Arsenic in Acute Promyelocytic Leukemia. Chemotherapy, 64(5-6), 238-247. https://doi.org/10.1159/000507805
Gurnari C, et al. When Poisons Cure: the Case of Arsenic in Acute Promyelocytic Leukemia. Chemotherapy. 2019;64(5-6):238-247. PubMed PMID: 32521534.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - When Poisons Cure: The Case of Arsenic in Acute Promyelocytic Leukemia. AU - Gurnari,Carmelo, AU - De Bellis,Eleonora, AU - Divona,Mariadomenica, AU - Ottone,Tiziana, AU - Lavorgna,Serena, AU - Voso,Maria Teresa, Y1 - 2020/06/10/ PY - 2020/03/30/received PY - 2020/04/05/accepted PY - 2020/6/11/pubmed PY - 2020/6/11/medline PY - 2020/6/11/entrez KW - Acute promyelocytic leukemia KW - All-trans-retinoic acid KW - Antitumor activity KW - Arsenic KW - Targeted therapy SP - 238 EP - 247 JF - Chemotherapy JO - Chemotherapy VL - 64 IS - 5-6 N2 - Arsenic has been known for centuries for its double-edged potential: a poison and at the same time a therapeutic agent. The name "arsenikon," meaning "potent," speaks itself for the pharmaceutical properties of this compound, questioned and analyzed for at least 2000 years. In the last decades, acute promyelocytic leukemia (APL) has evolved from a highly fatal to a curable disease, due to the use of all-trans-retinoic acid and, more recently, arsenic trioxide combinations. The success of these entirely chemo-free regimens increased the awareness of APL and reduced the prevalence of early deaths, which was an impending issue in this disease. Further improvements are expected with the next use of oral arsenic formulations, which will allow a complete outpatient approach, at least in the post-induction settings, further improving patients' quality of life. The wide use of standardized approaches in APL will also help unravel long-standing open questions, including the pathogenesis, prevention, and treatment of the differentiation syndrome and of short-term organ toxicities. In the long term, the study of survivorship issues, such as fertility and organ-related and psychological damages, in the increasing number of survivors will help further improve their life after APL. SN - 1421-9794 UR - https://www.unboundmedicine.com/medline/citation/32521534/When_Poisons_Cure:_The_Case_of_Arsenic_in_Acute_Promyelocytic_Leukemia L2 - https://www.karger.com?DOI=10.1159/000507805 DB - PRIME DP - Unbound Medicine ER -
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