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Initiating TRISENOX therapy for your relapsed or refractory APL patients

If you have not achieved remission following first-line therapy for acute promyelocytic leukemia (APL), TRISENOX® (arsenic trioxide) injection has proven to be an important second-line treatment option. Prescribing TRISENOX can give new hope to your relapsed or refractory APL patients.

Recent studies have demonstrated the role of reverse transcriptase-polymerase chain reaction (RT-PCR) testing throughout treatment in the assessment of disease progression and the evaluation of therapy management.1-4 In this section you will learn more about RT-PCR testing and how it relates to treatment of your APL patients.

Proper patient management is essential for success with TRISENOX therapy. There are specific management guidelines, including monitoring for differentiation syndrome, electrolyte imbalances, blood chemistry abnormalities, QT prolongation, hyperleukocytosis, rash, and other potential side effects.

TRISENOX offers manageable treatment schedules for you and your patients. Therapy with TRISENOX does not require premedication, and TRISENOX can be administered in an outpatient setting. It is given intravenously, usually over 1 to 2 hours.

TRISENOX is indicated for induction of remission and consolidation in patients with APL who are refractory to, or have relapsed from, retinoid and anthracycline chemotherapy, and whose APL is characterized by the presence of the t(15;17) translocation or PML/RAR-alpha gene expression.
1. Lowenberg B, Griffin JD, Tallman MS. Acute myeloid leukemia and acute promyelocytic leukemia. Hematology Am Soc Hematol Educ Program. 2003;82-101.
2. Diverio D, Rossi V, Avvisati G, et al. Early detection of relapse by prospective reverse transcriptase-polymerase chain reaction analysis of the PML/RAR alpha fusion gene in patients with acute promyelocytic leukemia enrolled in the GIMEMA-AIEOP multicenter "AIDA" trial. GIMEMA-AIEOP Multicenter "AIDA" Trial. Blood. 1998;92:784-789.
3. Lo Coco F, Diverio D, Avvisati G, et al. Therapy of molecular relapse in acute promyelocytic leukemia. Blood. 1999;94:2225-2229.
4. Lo Coco F, Diverio D, Falini B. Genetic diagnosis and molecular monitoring in the management of acute promyelocytic leukemia. Blood. 1999;94:12-22.

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