Objective: To systematically review the efficacy and safety of arsenic trioxide (ATO) in treatment of acute promyelocytic leukemia (APL). Methods: The Cochrane Library (Issue 1, 2009), Cochrane Central Register of Controlled Trials (from 1970 to January 2009), MEDLINE (from 1978 to October 2008), EMBASE (from 1950 to March 2009), Chinese Biological Medical Literature Database (from 1978 to December 2008), China National Knowledge Infrastructure (CNKI, from 1994 to December 2008), and China Medical Academic Conference Database (from 1994 to December 2008) were electronically searched. We also searched the Meta-Register of controlled trials, Conference Proceedings of American Society of Hematology (from 1946 to December 2008) and Conference Proceedings of American Society of Clinical Oncology (from 1946 to December 2008) on the internet for grey literature. The related journals in the library of Third Military Medical University were hand-searched. The randomized controlled trials (RCTs) of ATO in treatment of APL were included. We adopted complete remission, overall survival rate, disease free survival rate, time to complete remission, relapse rate, mortality and adverse reactions as outcome indicators. Data were entered and analyzed with the Cochrane review manager software 5.0 (RevMan 5.0). Results: After merger of the included trials, five eligible RCTs with 328 cases were included. All the RCTs focused on the comparison of all-trans retinoic acid (ATRA) plus ATO regimen with ATRA monotherapy. Meta-analysis showed that the effect indexes for time to complete remission, two-year disease free survival rate, relapse rate, incidence of edema and incidence rate of QT interval prolongation were -1.20 [-1.68, -0.72], 8.64 [1.66,45.00], 0.21 [0.09,0.47], 4.16 [1.46,11.79] and 22.10 [2.75,177.49], respectively. The influences on other outcome indicators such as complete remission and leukocytosis were statistically non-significant. Conclusion: ATO can prolong disease free survival and reduce the time to complete remission and relapse rate of newly diagnosed APL patients, and increase the incidence of edema and prolongation of corrected QT interval during the treatment. Due to limitation of the included trials, this conclusion needs to be validated by further studies.

Objective To investigate the SENP1 and c-myb gene expression and their correlations in bone marrow specimens in the patients with acute lymphoblastic leukemia (ALL ) to provide the basis for expounding the role ,mechanism and prognosis of SENP1 and c-myb in ALL .Methods 31 patients diagnosed with ALL (22 cases of B-ALL ,1 case of T-ALL and 8 cases of uncate-gorized ALL ;6 cases in the low/medium risk group ,25 cases in the high risk group) and 31 patients with proliferative bone marrow and hyperplastic anemia diagnosed by the morphology were taken as the control group .The real-time PCR and immunocytochemical staining(SP method) were adopted to detect the mRNA and protein expressions of SENP1 and c-myb in the bone marrow specimens of the ALL patients and the control group .Results The expression of SENP1 and c-myb were both increased in the bone marrow specimens and smears of ALL patients ,which showed the statistical difference compared with the control group (P< 0 .05) ,the Pearson correlation analysis found that the high expression of SENP1 and c-myb had correlation .The expression of SENP1and c-myb in the low/medium risk group were lower than that in the high risk group ,but the difference had no statistical significance . Conclusion The high expression of SENP1 and c-myb exists in the bone marrow specimens of the ALL patients ,SENP1 and c-myb could possibly have the correlation with the occurrence and development of ALL ;but now the differences of SENP1 and c-myb ex-pression among different risk groups of ALL patients are yet to be proven .

The studies have demonstrated that arsenic trioxide (ATO) in combination with all-trans retinoic acid (ATRA) takes effects in treatment of acute promyelocytic leukemia (APL) through different underlying mechanisms. This has established the molecular foundation of ATO plus ATRA therapy. Currently, ATO plus ATRA has also been widely used in clinical practice.

Objective To compare the efficacy and safety of arsenic trioxide ( ATO) with all-trans retinoic acid ( ATRA) for the treatment of acute promyelocytic leukemia ( APL) . Methods We searched the database of Cochrane Library ( Issue 1,2009) ,CENTRAL ( 1970 to 2009) ,Medline ( 1978 to 2008) ,EMBASE ( 1950 to 2009) ,CBM ( 1978 to 2008) ,CNKI ( 1994 to 2008) and CMAC ( 1994 to 2008) . We also searched the Meta register,Conference Proceedings of American Society of Hematology ( 1946 to 2008) and American Society of Clinical Oncology ( 2004 to 2008) on the internet for grey literature. We had searched the related journals in the library of Third Military Medical University,too. We included randomized controlled trials which compared ATO with ATRA for the treatment of APL. We adopt complete remission rate,overall survival rate, disease-free survival rate,time to complete remission,relapse rate,mortality and adverse reactions as result indicators. Data were entered and analyzed with the Cochrane review manager software ( Revman 5. 0) . Results Four eligible randomized controlled trials ( RCTs) were included ( n =243) . All the RCTs were methodologically graded as B. They all are focusing on the comparison of ATO monotherapy with ATRA monotherapy in treating newly diagnosed APL patients. Meta analysis showed that effect index for complete remission,2-year disease-free survival,time to complete remission,relapse rate and mortality was 0. 96 ( 0. 50,1. 86) ,2. 76 ( 0.71,10.66) ,-1.30 d ( -1.83,-0.78) ,0.86 ( 0.45,1.63) ,and 1.15 ( 0.45,2.95) ,respectively. All indicated no statistically significant difference. Effect index for incidence of liver dysfunction was 3. 03 ( 1. 25, 7. 37) ,which showed statistically significant difference between ATO group and ATRA group. Conclusion ATO is not superior to ATRA in treating newly diagnosed APL patients regarding complete remission,diseasefree survival rate,time to complete remission,relapse rate and mortality. What is worse,it will increase the incidence of liver dysfunction during treatment. Due to limitation of included trials,this conclusion need to be validated by further studies.