Arsenic and all-trans retinoic acid as induction therapy before autograft in a case of relapsed resistant secondary acute promyelocytic leukemia

Arsenic trioxide has recently been reported to be successful in the treatme nt of promyelocytic leukemia, Several concerns about the use of this toxic agent are currently reducing its potential clinical use even in severely ii i patients. In this report rye describe the results achieved by As2O3 with all-trans retinoic acid in a patient suffering from secondary, relapsed, re sistant promyelocytic leukemia. Several complications, including sepsis and an extensive area of skin necrosis, did not allow us to treat the patient further,vith chemotherapy. With As2O3 and ATRA therapy, the patient obtaine d a complete molecular remission without any significant toxicity and, subs equently, it was possible to perform a bone marrow autograft in a state of complete remission.