Cancers & treatments·Regimen libraryInduction

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

28-day cycle, induction until complete remission (up to 60 days), then 4 consolidation coursesOralIntravenous Daily oral course

Components

Drug	Dose	Route	Days	Note
Tretinoin (ATRA) Oral retinoid (differentiation agent)	45 mg/m² per day in two doses	Oral	D1-28
Arsenic trioxide Inorganic arsenical (differentiation agent)	0.15 mg/kg per day	IV	D1-28

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

Acute myeloid leukaemia

Products

Tretinoin (all-trans retinoic acid, ATRA)Arsenic trioxide

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

7+3 (cytarabine + anthracycline) ± midostaurin

Fit adults with newly diagnosed AML; midostaurin for FLT3-mutated disease (quizartinib for FLT3-ITD)

every 28 days × 1-2

Venetoclax + azacitidine

Newly diagnosed AML unfit for intensive chemotherapy

every 28 days

ADE (cytarabine, daunorubicin, etoposide)

Induction for younger adults with acute myeloid leukaemia in the UK MRC and NCRI trials; an alternative to 7+3

every 28 days × 2

All regimens Blinatumomab →