Oral arsenic trioxide for relapsed acute promyelocytic leukemia in pediatric patients

Four patients (age 311 years at diagnosis) with relapsed acute promyelocytic leukemia (APL), 1238 months from diagnosis, were treated with oral arsenic trioxide (As2O3). One patient was treated with oral As2O3 monotherapy and chemotherapy. Three patients failed initial oral or intravenous As2O3 monotherapy were treated with oral As2O3 plus ATRA followed by long-term oral maintenance (cumulative As2O3 dose 2802,100?mg). All patients achieved molecular remission, at a median follow up of 122 (10132) months with no adverse effects. Oral As2O3, particularly in prolonged maintenance with oral ATRA may obviate the need of stem cell transplantation in relapsed pediatric APL. Pediatr Blood Cancer 2012; 58: 630632. (c) 2011 Wiley Periodicals, Inc.