Arsenic trioxide (ATO)
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DRUG-ATO |
|---|---|
| Type | Drug |
| Aliases | ATOArsenic trioxideAs2O3TrisenoxТриоксид арсену |
| Status | reviewed 2026-04-25 | pending_clinical_signoff |
| Diseases | DIS-APL |
| Sources | SRC-APL0406-LOCOCO-2013 SRC-ELN-APL-2019 SRC-NCCN-AML-2025 |
Drug Facts
| Class | Differentiation + apoptosis-inducing agent (PML-RARα degrader) |
|---|---|
| Mechanism | Binds PML moiety of PML-RARα fusion → SUMOylation, ubiquitination, and proteasomal degradation of the oncoprotein. Synergizes with ATRA. With ATRA, makes APL the first chemotherapy-curable acute leukemia. |
| Typical dosing | APL induction: 0.15 mg/kg IV daily until complete remission (~28-35 days). Consolidation per APL0406 / LO-CoCo: ATO 5 days/week × 4 weeks every 8 weeks for 4 cycles + ATRA 2 weeks every 4 weeks for 7 cycles. |
| Ukraine registered | True |
| NSZU reimbursed | True |
| Ukraine last verified | 2026-04-27 |
Warnings
- Differentiation syndrome (same as ATRA)
- QT prolongation, torsades de pointes — baseline + serial ECG; correct K+ >4.0, Mg2+ >1.8
- APL syndrome — dyspnea, fluid retention, fever
Notes
ATO + ATRA chemo-free regimen for low-risk APL (WBC ≤10) — APL0406 trial: 2-y EFS 97% vs 86% with ATRA+chemo (AIDA). For high-risk APL (WBC >10): ATRA + ATO + idarubicin OR classic AIDA. Mandatory daily ECG + electrolyte monitoring during induction; aggressive K+/Mg2+ repletion. Differentiation-syndrome prophylaxis as for ATRA.
Used By
Regimens
REG-ATRA-ATO-APL- ATRA + Arsenic Trioxide (APL low/intermediate-risk) — APL0406 / LO-CoCo scheduleREG-ATRA-ATO-APL-SALVAGE- ATRA + ATO salvage for R/R APL post front-lineREG-ATRA-ATO-IDA-APL- ATRA + ATO + Idarubicin (APL high-risk) — modified APL0406 / AIDA-styleREG-GEMTUZUMAB-APL- Gemtuzumab ozogamicin for relapsed APL with maintenance