The University of Hong Kong (HKU) has achieved a significant breakthrough in blood cancer treatment with the development of the world's first oral arsenic trioxide formulation for acute promyelocytic leukemia (APL). This groundbreaking therapy has demonstrated an exceptional 97 percent cure rate and has received recognition from both the U.S. Food and Drug Administration and European Medicines Agency.
Clinical Impact and Patient Benefits
Dr. Harinder Gill, clinical associate professor in HKU's Department of Medicine and lead investigator of the study, emphasizes that the new oral treatment dramatically reduces early mortality rates from 16 percent to below 5 percent. This advancement represents a crucial improvement in patient care, particularly given that Hong Kong sees 25 to 30 new APL cases annually.
The oral formulation eliminates the need for prolonged hospitalization, which was previously required for intravenous arsenic treatments or while waiting for bone marrow transplants. Patients now only need 14 to 21 days of initial hospital observation until their blood cell counts and coagulation levels stabilize. The complete treatment course spans approximately 70 days, with follow-up visits scheduled every one to two months.
Cost-Effectiveness and Accessibility
Traditional intravenous arsenic treatment could cost between US$10,000 to US$20,000 per week, placing a significant financial burden on patients. The new oral treatment offers a more cost-effective alternative while maintaining efficacy. In Hong Kong, all diagnosed APL patients can now access this treatment through public hospitals, with medication costs fully covered through Queen Mary Hospital.
Real-World Treatment Success
The treatment's effectiveness is demonstrated through its successful implementation, having already benefited over 430 patients with more than 90 percent achieving remission. One patient, Wong, who was diagnosed with APL in April 2023, shared her experience after switching from traditional treatments that had cost her approximately HK$2.6 million. She described the oral medication's taste as similar to seawater or soy sauce and highlighted her ability to maintain normal work activities during treatment.
"The development of oral-ATO is a game-changer for APL patients. It provides a convenient and effective treatment option that significantly enhances their quality of life," states Dr. Gill.
Future Applications and Research
The HKU research team is expanding their investigation to explore the potential applications of oral arsenic in treating other forms of acute leukemia. Dr. Gill also notes that arsenic's anti-inflammatory properties could lead to promising applications in treating autoimmune conditions such as rheumatoid arthritis and lupus.
