Several countries around the world are using arsenic trioxide to treat myeloid leukemia, however high drug prices limit the population’s access to this promising drug.
For a few years Cuba has produced and supported the use of the drug as a first-line treatment for such cancer cases, completely free, as is medical care in the country.
Arsenic is a heavy metal, however, its clinical use is documented in literature more than two thousand years old, with multiple applications.
Specimens containing such a substance have been used in medicine for over two thousand years.
Treatments using the poison were used in the United States and Europe over a hundred years ago for hematological cancer and infections, but modern chemotherapy and antibiotics replaced them.
In the case of promyelocytic leukemia, arsenic trioxide has produced great results and was recovered in 1998 when Chinese hematologists became aware of its benefits in order to achieve the remission of this disease.
Cuba began using it in 2000 on patients with this type of leukemia who were treated with retinoic acid – a leading global medicine for the disease – but relapsed, Dr. Carlos Hernández of the Institute of Hematology and Immunology (IHI) told Prensa Latina exclusively.
“We used it in 10 patients in this condition and we achieved remission in eight of them,” said the research leader, who has spent almost two decades working with the drug.
“With retinoic acid we achieved a survival rate of 83 percent at five years and a cure rate of 83.5 percent,” said the specialist.
However, with this drug, up to 20% of patients reported relapses, but with arsenic trioxide this indicator falls dramatically to less than 3.5% of cases, Hernández said.
He explained that promyelocytic leukemia is known in popular culture as fulminant leukemia because it kills in the first week due to hemorrhagic disorders. “We always lose 10% of cases, 10 out of hundred do not manage to survive the initial days of the severe coagulation disorders”, he added.
“But if we manage to get the patient through this period with predominant treatment, supporting it with platelets and plasma, the 90% that recovered have very little chance of relapsing into the disease after being treated with arsenic trioxide,” he said.
“There are people who, after five years of remission, have a 90% chance of survival. We see them as cured,” he said.
Hernández considered that this drug is one of the great achievements of Cuban medicine and pharmacology.
“It is recognized worldwide, but its price is very high, a bulb of arsenic trioxide can cost 200 dollars or euros in many countries,” he said.
The treatment comprises daily treatments for 42 or 45 days which on average is priceless, so it is not accessible to everyone in other countries, unlike Cuba, he said.
According to the specialist, on average in the Caribbean country, there are 30 new cases of promyelocytic leukemia a year.
This is the most common type of hematologic cancer in the Latino population, most commonly in people over 10 and under 60.
It is slightly more common in men than in women, but the average lifetime risk in both sexes is less than half of 1%. For the treatment with arsenic trioxide the drug is given intravenously (IV)
in Cuba, and as its base component is a toxic heavy metal, but maintaining the established treatment regimen and monitoring the cardiotoxicity eliminates any risk to life.
To do this, the patient is given electrocardiogram two or three times a week and at the slightest indication of discomfort, the treatment is suspended for several days until it stabilizes.
So far, at the IHI there have been no deaths linked to the medication, nor people who have been left with subsequent liver damage. (PL)
Photos: Pixabay – (Translated by Shanika Whight – firstname.lastname@example.org)