Table 1

Major abnormalities and arsenic retention of patients

AbnormalitiesPatients, n (%)Healthy controls, n (%)P value
Lower WBC count 1 (0.9)* 1.000 
Cardiovascular events    
 Elevated myocardial enzymes 5 (4.5) 1 (0.9) .212 
 Long Q-T interval NA 
 T wave change 14 (12.5) 15 (13.4) .842 
 Echocardiogram abnormality 1 (0.9) 1.000 
Liver dysfunction    
 Liver dysfunction, grade 1 17 (15.2) 2 (1.8) <.001 
 Hepatic steatosis 48 (42.9) 20 (17.9) <.001 
Kidney and GI dysfunction    
 Elevated creatinine NA 
 Albuminuria 1 (0.9) 1.000 
 Fecal occult blood test NA 
Diabetes 6 (5.4) 5 (4.5) .757 
Neurological disorders 1 (0.9)§ 1 (0.9) 1.000 
Potential secondary tumor    
 Elevated serum tumor markers 3** NA NA 
 Thoracic neoplasm on CXR NA 
 Abdominal neoplasm on BUS NA 
 Skin lesion 8 (7.1)†† 5 (4.5)‡‡ .391 
 Breast cancer 1 (0.9) 1.000 
Arsenic retention, mean ± SD    
 Plasma, ng/g 6.43 ± 1.56 8.99 ± 1.14 <.001 
 Urine, ng/mL 45.28 ± 33.28 57.55 ± 33.61 .004 
 Hair, ng/g¶¶ 195.43 ± 202.25 198.23 ± 133.16 .340 
 Nails, ng/g¶¶ 294.65 ± 158.94 338.80 ± 212.27 .761 
AbnormalitiesPatients, n (%)Healthy controls, n (%)P value
Lower WBC count 1 (0.9)* 1.000 
Cardiovascular events    
 Elevated myocardial enzymes 5 (4.5) 1 (0.9) .212 
 Long Q-T interval NA 
 T wave change 14 (12.5) 15 (13.4) .842 
 Echocardiogram abnormality 1 (0.9) 1.000 
Liver dysfunction    
 Liver dysfunction, grade 1 17 (15.2) 2 (1.8) <.001 
 Hepatic steatosis 48 (42.9) 20 (17.9) <.001 
Kidney and GI dysfunction    
 Elevated creatinine NA 
 Albuminuria 1 (0.9) 1.000 
 Fecal occult blood test NA 
Diabetes 6 (5.4) 5 (4.5) .757 
Neurological disorders 1 (0.9)§ 1 (0.9) 1.000 
Potential secondary tumor    
 Elevated serum tumor markers 3** NA NA 
 Thoracic neoplasm on CXR NA 
 Abdominal neoplasm on BUS NA 
 Skin lesion 8 (7.1)†† 5 (4.5)‡‡ .391 
 Breast cancer 1 (0.9) 1.000 
Arsenic retention, mean ± SD    
 Plasma, ng/g 6.43 ± 1.56 8.99 ± 1.14 <.001 
 Urine, ng/mL 45.28 ± 33.28 57.55 ± 33.61 .004 
 Hair, ng/g¶¶ 195.43 ± 202.25 198.23 ± 133.16 .340 
 Nails, ng/g¶¶ 294.65 ± 158.94 338.80 ± 212.27 .761 

BUS, B-ultrasound; CA125, serum carbohydrate antigen 125; CEA, carcino embryonic antigen; CXR, chest X-ray; GI, gastrointestinal; NA, not available; NSE, neuron specific enolase; SD, standard deviation; WBC, white blood cells.

*

One patient was later diagnosed as the third relapse of APL.

No acute myocardial infarction. 2 had histories of heart diseases before APL.

One patient had rheumatic heart disease 1 wk after initial therapy, who also had albuminuria probably as a result of diabetes.

Only grade 1 liver dysfunction was observed in patients and healthy controls.

§

One patient had depression before APL that was well controlled by medication.

One patient had essential tremor.

**

Three patients had a mild and transient elevation in NSE, CEA, and CA125, respectively, and retests were normal.

††

Two patients had hyperpigmentation, 1 had hypopigmentation, and 5 had hyperkeratosis/hyperplasia.

‡‡

Two had hyperpigmentation and 3 had hyperkeratosis.

¶¶

Patients within 6 mo off ATO were not included because of high retention of arsenic.

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