Treating a form of leukaemia with a combination of arsenic and a form of vitamin A cures most patients for five or more years, researchers have found.

The result suggests the therapy could be promoted as a first-line treatment for acute promyelocytic leukaemia (APL), a subtype of myeloid leukaemia, which affects white blood cells.

For more than five years, Zhu Chen and colleagues followed 85 patients who were prescribed a combination of all-trans retinoic acid and arsenic trioxide. The researchers report that 80 patients entered into complete remission at the end of the analysis. Previous research had shown the efficacy of the vitamin A-derivative treatment in the short term, but the treatment had not studied over a longer time frame.

The researchers did not find any associated long-term problems in the patient's heart or lungs, and no secondary cancers appeared. Two years after their treatments, the patients had arsenic blood and urine levels well below safety limits, and only slightly higher than controls. The treatment was effective for different subgroups of APL and worked better than either drug given alone.

The authors say its high efficacy and minimal toxicity suggest that the combination treatment could be promoted to a front-line therapy for APL patients.

Source: Proceedings of the National Academy of Science

Article #08-13280: Long-term efficacy and safety of all-trans retinoic acid/arsenic trioxide based therapy in newly diagnosed acute promyelocytic leukemia," by Jiong Hu, Yuan-Fang Liu, Chuan-Feng Wu, Fang Xu, Zhi-Xiang Shen, Yong-Mei Zhu, Jun-Min Li, Wei Tang, Wei-Li Zhao, Wen Wu, et al.

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