A Review of Arsenic Trioxide in the Treatment of Acute Promyelocytic Leukemia: Clinical Efficacy, Toxicity, and Future Directions

Abstract

Acute promyelocytic leukemia (APL) is a severe and life-threatening form of leukemia characterized by unique genetic and chromosomal abnormalities, often leading to fatal complications such as hemorrhage and embolism. Arsenic trioxide (ATO) has become a key therapeutic agent for APL, achieving high remission rates, including in patients with relapsed disease, and offering advantages over other treatments such as bone marrow transplantation and all-trans retinoic acid (ATRA). This review examines the chemical and pharmacological properties of ATO, its mechanisms of action in APL treatment, and its clinical efficacy and toxicity based on studies conducted worldwide. Additionally, this review explores potential applications of ATO beyond APL and discuss future research directions to expand its therapeutic scope in clinical settings.