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Memorial Sloan-Kettering Cancer Center and Department of Medicine, and the Joan and Sanford Weill Medical College of Cornell University, New York, New York, USA
Correspondence: Steven L. Soignet, M.D., Developmental Chemotherapy Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York 10021-6007, USA. Telephone 212-639-8984; Fax 212-717-3172; e-mail: soignets{at}mskcc.org
Acute promyelocytic leukemia (APL) has unique clinical, cytogenetic, and molecular features and is one of the most potentially curable human malignancies. The current standard treatment given to patients with newly diagnosed APL con-sists of all-trans retinoic acid and anthracycline-based cytotoxic chemotherapy, which is highly effective for remission induction. However, despite the potential for cure with existing treatments, approximately 20%-30% of patients relapse and require salvage therapy. Reports of the safety and efficacy of arsenic trioxide from centers in China led to a pivotal trial of this agent in the United States for patients with relapsed APL. In an initial pilot study, 11 of 12 patients experienced a complete response, and a subsequent multicenter trial confirmed the efficacy and safety of arsenic trioxide for remission induction in this patient population. Additional trials are under way to evaluate the use of this agent alone or as part of a chemotherapy regimen for consolidation and maintenance of patients with APL.
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