Delayed Recovery of Normal Hematopoiesis in Arsenic Trioxide Treatment of Acute Promyelocytic Leukemia: A Comparison to All-trans Retinoic Acid Treatment

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概要

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• Objective To examine laboratory data including total blood cell count, leukocyte morphology and coagulation parameters during treatment for acute promyelocytic leukemia (APL) at a single institute, and compare the precise differences between all-trans retinoic acid (ATRA) and arsenic trioxide (As2O3) treatment.Patients and Methods Sixteen patients with APL who were treated with ATRA or As2O3 alone and achieved complete remission (CR) were analyzed. ATRA 45 mg/m2/day was given orally until CR. As2O3 0.15 mg/kg/day was given intravenously until leukemic blasts and promyelocytes were eliminated from the bone marrow.Results All 7 patients in the ATRA-treated group were primary cases and all 9 patients in the As2O3-treated group were relapsed cases after the achievement of CR with the ATRA. There was no difference in the data before treatment between these two groups. The duration of leukocytopenia and neutropenia during As2O3 treatment was significantly longer than those of ATRA treatment. The nadir of leukocyte and neutrophil counts was observed later in the As2O3-treated group. Terminal neutrophil differentiation was observed more obviously in the ATRA-treated group. The red blood cell count and hemoglobin concentration decreased significantly at the end of As2O3 treatment and were lower than those of ATRA treatment. Platelets recovered earlier in the ATRA-treated group. Coagulation parameters were not significantly changed between the two groups.Conclusion In comparison with ATRA treatment, the recovery of several components in the peripheral blood cells was delayed in As2O3 treatment. Therefore we should pay more and longer attention in As2O3 treatment.

• 社団法人　日本内科学会の論文

著者

• OHNO Ryuzo

  Aichi Cancer Center

• OHNISHI Kazunori

  Department of Internal Medicine, Hamamatsu University School of Medicine

• NAKAO Shinji

  Kanazawa University Hospital

• KOBAYASHI Miki

  Department of Hematology and Oncology, Nagoya University Graduate School of Medicine

• Shinagawa K

  Okayama Univ. Hospital Okayama Jpn

• Shinagawa Katsuji

  岡山大学 第2内科

• Shinjo Kaori

  浜松医科大学 内科学第3

• SHINJO Kaori

  Department of Internal Medicine, Hamamatsu University School of Medicine

• NAITO Kensuke

  Department of Internal Medicine, Hamamatsu University School of Medicine

• SAHARA Naohi

  Department of Internal Medicine, Hamamatsu University School of Medicine

• SHIGENO Kazuyuki

  Department of Internal Medicine, Hamamatsu University School of Medicine

• Takeshita Akihiro

  Laboratory Medicine, Hamamatsu University School of Medicine

• NAKAMURA Satoki

  Department of Internal Medicine III, Hamamatsu University School of Medicine

• MAEKAWA Masato

  Laboratory Medicine, Hamamatsu University School of Medicine

• Sahara Naohi

  浜松医科大学 内科学第3

• Nakamura Satoki

  県西部浜松医療センター 血液科

• Nakamura Satoki

  Department Of Internal Medicine Iii Hamamatsu University School Of Medicine

• Takeshita A

  The Third Department Of Internal Medicine Hamamatsu University School Of Medicine

• Tomida Akihiro

  癌研究会癌化学療法センター

• Kobayashi Miki

  Department Of Hematology Hamamatsu Medical Center

• Shirafuji Naoki

  Department Of Hematology Kanazawa University

• Shigeno Kazuyuki

  Japan Adult Leukemia Study Group Hamamatsu Jpn

• Sunami K

  Department Of Hematology National Hospital Organization Okayama Medical Center

• Shinagawa Katsushi

  The Second Department Of Internal Medicine

• Shinagawa Katsuji

  Department Of Biopathological Science Okayama University Graduate School Of Medicine And Dentistry

• Shinagawa Katsuji

  Division Of Hematology/oncology Okayama University Medical School

• Nakao Shinji

  Third Department Of Medicine Kanazawa University

• Kobayashi Miki

  Department Of Applied Analysis And Complex Dynamical Systems Graduate School Of Informatics Kyoto Un

• Ohnishi Kazunori

  Department Of Dermatology Gunma University Graduate School Of Medicine

• Takeshita Akihiro

  Third Department Of Internal Medicine Hamamatsu University School Of Medicine

• Takeshita Akihiro

  Department Of Medicine Iii Hamamatsu University School Of Medicine

• Takeshita Akihiro

  Hamamatsu Univ. School Of Medicine Shizuoka Jpn

• Sahara Naohi

  Department Of Internal Medicine Iii Hamamatsu University School Of Medicine

• Sugiyama Katsuki

  Division Of Hematology And Oncology Department Of Internal Medicine The Jikei University School Of M

• Sahara Naohi

  Department Of Hematology Kanto Rosai Hospital

• Naito Kensuke

  Department Of Hematology Hamamatsu Medical Center

• Ohnishi Kazunori

  Department Of Cell Pathology Graduate School Of Medical Sciences Kumamoto University

• OHNO Ryuzo

  Aichi Cancer Center, Nagoya

• SHINJO Kaori

  Department of Internal Medicine III, Hamamatsu University School of Medicine

• KOBAYASHI Miki

  Department of Internal Medicine III, Hamamatsu University School of Medicine

• SAHARA Naohi

  Department of Internal Medicine III, Hamamatsu University School of Medicine

• SHIGENO Kazuyuki

  Department of Internal Medicine III, Hamamatsu University School of Medicine

• NAITO Kensuke

  Department of Internal Medicine III, Hamamatsu University School of Medicine

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