ארסן

לדר' ציצוביץ שלום רב, קראתי את תשובותיך מחודש ספט' 2002 לגבי התרופה ארסן לחולי apl. האם נוסף מידע חדש? האם זה קיים ריפוי מוחלט. אודה תשובתך בהקדם. תודה ויום טוב.

ארסן משמש כטיפול קו שני לחולי APL לאחר התלקחות או לאחר שלא הגיבו לטיפול קו ראשון. קשה לדבר על החלמה בשלב זה עד שיהיו יותר נתונים ולאורך זמן. ראי ציטוט מעדכון אחרון בנושא: The Current Role of Arsenic Trioxide in APL Arsenic trioxide to induce second remission in relapsed or refractory patients Investigators from China reported that arsenic trioxide induces CR in patients with relapsed and refractory APL. Soignet and colleagues conducted a pilot study of twelve relapsed APL patients treated with arsenic trioxide at doses ranging from 0.06 to 0.2 mg/kg/day until leukemic cells were eliminated from the bone marrow as determined by light microscopy. Eleven patients obtained CR, with 8 of the 11 patients who initially tested positive for the PML/RAR fusion transcript later becoming negative. A multicenter trial of patients confirmed the high CR rate (85%). Furthermore, approximately 78% of patients had no evidence of the leukemic clone by PCR after 2 courses of arsenic trioxide. The most important toxicities include prolongation of the QTc interval and the APL differentiation syndrome, a cardiorespiratory distress syndrome with pulmonary infiltrates, reminiscent of the RAS and responsive to dexamethasone. Preliminary studies in a small cohort of patients testing lower doses of arsenic trioxide suggest efficacy similar to that of the standard dose with less toxicity. Currently, arsenic trioxide is considered the treatment of choice for patients with relapsed or refractory disease הציטוט מתוך: http://www.asheducationbook.org/cgi/content/full/2003/1/82