Adverse effects of intravenous arsenic trioxide and their prevention

Objective To study the main side effects of As2O3 and the way of prevention. Methods The changes of body weight and various systems of body were observed after treatment with As2O3 injection. The arsenic content in blood, urine and hair was detected with atom absorbed-spectrum analysis. Results Mild reactions were observed in 57.43%(147/256) of the patients and they could subside after ceasation of arsenic treatment or allotherapy . Chronic mild poisoning manifestations including arsenic furuncle, liver dysfunction and peripheral nerve injury were found in 2.73%(7/256) of the patients and they subsided gradually after treatment. Chronic severe poisoning was found in 1.17% of the patients and all of them died of liver failure. As2O3 might cause decrease of peripheral blood WBC in catabatic patients.There was no infection after allopathy without ceasing arsenic medication. The results showed that As2O3 could distribute over and discharge from the plasma without accumulation in blood.The results also demonstrated the main route of excretion for As2O3 is through urine and there is definite accumulation in the hair 50 days after treatment. Conclusion Most of the side effects of As2O3 are mild and reconverable. Allotherapy could be effective to relieve the complications without stopping arsenic medication. A few patients with complicating hepatitis may suffer from chronic poisoning. As2O3 may cause increase of peripheral blood WBC in induced catabatic APL patients. The side effects must be prevented early.