Hemodialysis dependent patient with relapsed acute promyelocytic leukemia treated by arsenic trioxide
MUDr. Kateřina Benková1-2; MUDr. Zdeněk Kořístek, Ph.D.1-2; MUDr. Petra Richterová1-2; MUDr. Jana Mihályová1-2; Mgr. Dagmar Zámoravcová3; Ing. Karel Lach, CSc.3; prof. MUDr. Roman Hájek, CSc.1-2
1 Klinika hematoonkologie, Fakultní nemocnice Ostrava
2 Lékařská fakulta, Ostravská univerzita
3 Centrum hygienických laboratoří, Zdravotní ústav se sídlem v Ostravě
Arsenic trioxide (ATO) is a drug of choice in the treatment of relapsed acute promyelocytic leukemia (APL). Guidelines for the treatment of hemodialysis dependent patients with APL do not exist. Here we describe the treatment of relapsed APL in a hemodialysis dependent patient by ATO at the dose of 10 mg three times a week after hemodialysis with frequent monitoring of laboratory values and QT interval. Molecular remission was achieved without serious adverse events. The authors further discuss the use of ATO in hemodialysis dependent patients and conclude, that ATO can be safely and effectively used in such patients under the condition of close monitoring of toxicity and adverse events; assessment of the arsenic concentration in blood is not useful for treatment management.
acute promyelocytic leukemia, molecular relapse, arsenic trioxide, chronic hemodialysis
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