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Successful Treatment of Relapsed Acute Promyelocytic Leukemia in a Patient Receiving Continuous Ambulatory Peritoneal Dialysis With Oral Arsenic Trioxide

Wing-Yan Au, MRCP; Giselle T. Cheung, BSc; Tommy W. Yuen, PhD; Cyrus R. Kumana, MD; Yok-Lam Kwong, MD
Arch Intern Med. 2005;165(9):1067-1068. doi:10.1001/archinte.165.9.1067.
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Serious medical comorbidities generally preclude curative therapies for patients with leukemia. Arsenic trioxide (As2O3), both intravenous and oral, is highly effective for acute promyelocytic leukemia (APL).1 As arsenic is eliminated mainly by renal excretion, uremic patients are considered unsuitable for arsenic trioxide therapy. To our knowledge, there are no data on arsenic clearance during dialysis. A patient with APL who was receiving continuous ambulatory peritoneal dialysis (CAPD) was successfully treated with oral arsenic trioxide. We took this unique opportunity to study arsenic clearance during CAPD.

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Plasma and cellular arsenic levels during oral arsenic trioxide treatment for relapsed acute promyelocytic leukemia (to convert arsenic values to micromoles per liter, multiply by 0.0133). A, Study patient, who received continuous ambulatory peritoneal dialysis. Blood samples were obtained 2 hours after each arsenic trioxide treatment and at follow-up after cessation of treatment. Asterisks indicate time points at which concomitant plasma and peritoneal dialysate (PD) arsenic levels were measured. B, Fifteen patients with normal renal function. Error bars show median values and range.

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