Vitamin A and Arsenic for Leukemia Los Angeles CA

Acute promyelocytic leukemia (APL) is a subtype of acute myelogenous leukemia (AML), a cancer of the blood and bone marrow in which there is a deficiency of mature blood cells in the myeloid line of white blood cells and an excess of immature cells called promyelocytes. Signs and symptoms of acute promyelocytic leukemia are similar to other forms of AML. Symptoms include fever, fatigue, weight loss or loss of appetite, shortness of breath with exertion, anemia, easy bruising or bleeding, petechiae (flat, pin-head sized spots under the skin caused by bleeding), bone pain and joint pain and persistent or frequent infections. Acute promyelocytic leukemia represents 5-8% of AML in adults. The median age is approximately 40 years, which is considerably younger than the other subtypes of AML (70 years).

Vitamin A was the first fat-soluble vitamin to be isolated. It was discovered in 1913 as a result of its ability to prevent night blindness and xerophthalmia (a drying and hardening of the mucous membrane that lines the eyelids). In 1932, beta-carotene (pro-vitamin A) was discovered to be the precursor to vitamin A and it is sometimes referred to as provitamin A. Vitamin A belongs to a class of compounds called retinoids, which only occur in animal products. Retinoids with vitamin A activity occur in nature in three different forms: a) the alcohol, retinol, b) the aldehyde, retinal or retinaldehyde, and c) the acid, retinoic acid. Vitamin A requires fats as well as minerals in order to be properly absorbed from the digestive tract. Substantial amounts of vitamin A are stored in the liver, and therefore, it does not need to be supplied in the diet on a daily basis.

A study, published in the Proceedings of the National Academy of Sciences, appears to have concluded that it is possible to safely and successfully treat patients with cancer of the blood and bone marrow with a combination of arsenic and vitamin A. The FDA approved the use of arsenic trioxide (called Trisenox) for the treatment of patients with acute promyelocytic leukemia (APL) in 2000 only three years after the study of the drug was first started in the US. According to this new study, the combination of vitamin A and arsenic provided better results than either drug alone. There were 85 patients involved in the study. They received the combination drug and were then monitored for an average of 70 months. They found that 80 of the patients went in to complete remission (94 percent) and that 97 percent of them were alive for at least five years following the treatment. The therapy was well tolerated and the side effects were mild and reversible. There were no secondary malignancies reported and two years after the final dose of therapy, urine arsenic levels were well below toxic levels. Based on these findings the researchers are hopeful that this combination therapy will become one of the frontline therapies for people with newly diagnosed acute promyelocytic leukemia (APL).¹

¹ Hu J, Liu YF, Wu CF, et al. Long-term efficacy and safety of all-trans retinoic acid/arsenic trioxide-based therapy in newly diagnosed acute promyelocytic leukemia. PNAS. Feb2009.