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The Oncologist, Vol. 6, Suppl 2, 1-2, April 2001
© 2001 AlphaMed Press

SUPPLEMENT

Introduction: The History of Arsenic Trioxide in Cancer Therapy

Karen H. Antman

Columbia University College of Physicians and Surgeons, New York, New York, USA

Correspondence: Karen H. Antman, M.D., Wu Professor of Medicine and Professor of Pharmacology, Milstein Hospital Building-6N-435, Division of Oncology, 177 Ft. Washington Avenue, Columbia University, New York, New York 10032, USA. Telephone: 212-305-8602; Fax: 212-305-3035; e-mail: kha4{at}columbia.edu

Although arsenic can be poisonous, and chronic arsenic exposure from industrial or natural sources can cause serious toxicity, arsenic has been used therapeutically for more than 2,400 years. Thomas Fowler's potassium bicarbonate-based solution of arsenic trioxide (As2O3) was used empirically to treat a variety of disorders, and in 1878, was reported to reduce white blood cell counts in two normal individuals and one with "leucocythemia." Salvarsan, an organic arsenical for treating syphilis and trypanosomiasis, was developed in 1910 by Paul Ehrlich. In the 1930s, arsenic was reported to be effective in chronic myelogenous leukemia. After a decline in the use of arsenic during the mid-20th century, reports from China described a high proportion of hematologic responses in patients with acute promyelocytic leukemia (APL) who were treated with arsenic trioxide. Randomized clinical trials in the U.S. led to FDA approval of arsenic trioxide for relapsed or refractory APL in September 2000.

Key Words. Acute promyelocytic leukemia • Arsenic trioxide chemotherapy • Cancer • Leukemia




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