Acute pro myelocytic leukemia

Apart from DNA methylation studies, the second aspect of epigenetic misregulation involves disruption of histone acetylation and chromatin structure. Functional disruption of some HATs genes (such as the CBP and p300) is detected in some cancers, most notably, acute pro-myelocytic leukemia (51). This has lead to the hope that HD AC inhibitors will be useful for the treatment of this disease and a number of inhibitors are currently being assessed in clinical trials (see below). 

In recent times arsenic and arsenicals have been considered obsolete in medicine, because of their limited therapeutic value, multisystem toxicity, and apparent carcinogenic properties (SED-8, 502) (SED-9, 368). However, arsenic compounds have been used to treat various types of leukemia (1-3), including acute pro-myelocytic leukemia, chronic myelogenous leukemia, and multiple myeloma (4). Arsenic trioxide is effective in acute promyelocytic leukemia, achieving a complete... 

Cardiovascular A 26-year-old man was given arsenic trioxide for relapsed acute pro-myelocytic leukemia and after 14 days developed a fever (38 °C) and chest pain [18 ]. CT scan showed moderate pleural and pericardial effusions and arsenic trioxide was withdrawn. His chest pain deteriorated and the effusions enlarged, causing hypotension on day 16. An electrocardiogram showed a prolonged QT interval and sinus tachycardia and echocardiography was normal, except for diastolic ventricular failure due to the pericardial effusion. The authors thought that other causes were excluded and attributed the case to arsenic trioxide. 

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