OnCo

ATRA + arsenic trioxide

Checked 2026-09-09

Low or intermediate-risk acute promyelocytic leukaemia (WBC 10 × 10⁹/L or less)

One cycle

every 28 days
1781415212228Tretinoin (ATRA): 45 mg/m² per day in two doses, OralTretinoin (ATRA)Arsenic trioxide: 0.15 mg/kg per day, IntravenousArsenic trioxide
28-day cycle, induction until complete remission (up to 60 days), then 4 consolidation coursesOralIntravenous Daily oral course

Components

DrugDoseRouteDays
Tretinoin (ATRA)
Oral retinoid (differentiation agent)
45 mg/m² per day in two dosesOralD1-28
Arsenic trioxide
Inorganic arsenical (differentiation agent)
0.15 mg/kg per dayIVD1-28
Cycles
induction until complete remission (up to 60 days), then 4 consolidation courses
28-day cycle
Emetogenicity
Minimal (<10%)
G-CSF
Not routine

Notes

  • Differentiation syndrome: start dexamethasone 10 mg twice daily at the first sign; QTc and electrolytes with arsenic.

Used in

Source

Lo-Coco (APL0406), NEJM 2013

Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.

Other regimens for these cancers