Understanding
Trisenox®
(arsenic trioxide)
injection
International Myeloma Foundation
12650 Riverside Drive, Suite 206
North Hol ywood, CA 91607 USA
Telephone:
800-452-CURE
(USA & Canada)
818-487-7455
Fax: 818-487-7454
TheIMF@myeloma.org
www.myeloma.org
09/07
Table of Contents
Introduction
5
What is Multiple Myeloma?
5
What are the Stages of Multiple Myeloma? 6
What is Trisenox® and How Does it Work? 8
How is Trisenox® Being Investigated
in Multiple Myeloma?
9
What are the Possible Side Effects
of Trisenox®?
14
How is Trisenox® Given?
18
What is the Dose and Schedule
for Trisenox®?
18
How Can I Receive Treatment
with Trisenox®?
18
What Questions Should I Ask
My Healthcare Provider about Trisenox®?
19
Where Can I Get More Information?
19
About the IMF
20
Glossary
23
©2007, International Myeloma Foundation, North Hollywood, California
Introduction
You have been given this booklet to learn
more about a drug cal ed Trisenox® (arsenic
trioxide) injection. After reading this booklet
you should know:
n What Trisenox® is
n How Trisenox® works
n The possible side ef ects of Trisenox®
n How Trisenox® is given
This booklet is meant to provide you with
general information only. It is not meant to
replace the advice of your doctor or nurse.
Your doctor or nurse can answer questions
related to your specific treatment plan. Al
words that appear in bold type are defined
in the glossary at the end of the booklet.
What is Multiple Myeloma?
Multiple myeloma (also known as myeloma
and as plasma cel neoplasm) is a malig-
nancy of the immunoglobulin- (antibody)
producing plasma cel s found in the bone
marrow. It is a hematologic malignancy
resembling leukemia. However, the malig-
nant plasma cel s, or myeloma cel s, rarely
enter the bloodstream as in a true leukemia.
Instead, the myeloma cel s accumulate in the
bone marrow, causing:
n Disruption of normal bone marrow func-
tion, most commonly giving rise to anemia
(a low level of red blood cel s in the blood-
stream), although reduction in white blood
cel and platelet counts can also occur
4
5
n Damage to bone surrounding accumu-
n More than 3 areas of advanced lytic bone
lated myeloma cel s
lesions
n Release of an abnormal protein, mono-
n A high level of M protein in the blood or
clonal protein (M protein), into the blood-
urine
stream
Multiple myeloma is a serious malignancy,
n Suppression of normal immune function,
but it is treatable. Many patients experience
observed as reduced levels of normal
a series of responses, relapses, and remis-
immunoglobulins and increased suscepti-
sions. With new treatments, many patients
bility to infection
are able to live bet er and longer post-diag-
Myeloma cel s can also grow in the form
nosis.
of localized tumors or plasmacytomas.
Fol owing diagnosis, several options are
Plasmacytomas may be single or multiple
available for initial or frontline therapy. For
and either medul ary (confined within bone
patients who may be candidates for high-
marrow and bone) or extramedul ary (out-
dose therapy with transplant, various induc-
side of the bone). When there are multiple
tion regimens can be considered, including
plasmacytomas inside or outside bone, this
Thalomid® (thalidomide) with dexametha-
condition is also cal ed multiple myeloma.
sone, dexamethasone alone, or other dexa-
methasone-containing combinations. The
The Stages of Multiple Myeloma
combination of the alkylating agent melpha-
Stage I (low cell mass): Early disease.
lan plus prednisone, a simple oral therapy, is
The bone structure appears normal or close
an option for patients not considering bone
to normal on x-ray images; the number of
marrow (stem cel ) transplant with intravenous
red blood cel s and amount of calcium in the
high-dose melphalan. At the time of relapse,
blood are normal or close to normal, and the
newer agents are frequently required to
amount of M protein is very low.
achieve further response. Revlimid® (lenalido-
mide) is an important new agent available
Stage II (intermediate cell mass): An
for use in this set ing. Velcade® (bortezomib)
intermediate stage between stage I and I I
is also an important new agent available for
Stage III (high cell mass): More
relapsed myeloma.
advanced disease. One or more of the
fol owing are present:
n Anemia
n A high level of calcium in the blood
6
7
become more like non-malignant blood
What is Trisenox® and
cel s. Whether Trisenox® has this particular
How Does it Work?
activity in myeloma cel s remains to be
Trisenox® (arsenic trioxide) injection is a
seen.
type of anticancer agent that is derived from
n Trisenox® may also prevent myeloma cel s
arsenic, a natural y occurring compound that
from performing another biologic process
has been used for over two thousand years
cal ed angiogenesis (the growth of new
in Chinese and western medicine to treat a
blood vessels). As a result, cancer cel s
wide range of disorders. In the 1930s, natu-
are unable to obtain nutrients for survival
ral y occurring arsenic was found to be ef ec-
and growth from the bloodstream.
tive for treating a type of leukemia known as
n Trisenox® may also inhibit the growth of
chronic myelogenous leukemia (CML). More
myeloma cel s by inhibiting molecules in
recently, interest was renewed in this agent
the bone marrow and blood that promote
as an anticancer agent when researchers
cel ular growth.
reported promising results in patients receiv-
n
ing it for the treatment of acute promyelo-
Trisenox® may also disrupt the function of
mitochondria, smal structures within cel s
cytic leukemia (APL). In 2000, Trisenox®
that provide energy, by increasing the
was approved by the U. S. Food and Drug
production of reactive oxygen species.
Administration (FDA) for the treatment of APL,
and researchers have continued to explore
How is Trisenox® being
the use of Trisenox®® in the treatment of
investigated in Multiple Myeloma?
other cancers of the blood. Laboratory and
clinical trials continue to investigate whether
Laboratory StudieS
Trisenox® is safe and ef ective in the treat-
Trisenox® is approved by the FDA for the
ment of other blood disorders including multi-
treatment of acute promyelocytic leukemia
ple myeloma. Although the exact mechanism
(APL). However, it is being investigated for
for how Trisenox®® works continues to be
the treatment of multiple myeloma. Clinical
explored, its anticancer activity is believed
trials in patients with myeloma are based on
to arise from multiple processes:
studies of Trisenox® in myeloma cel lines and
n Trisenox® appears to cause cancer cel s to
cel s from patients with myeloma in the labo-
self-destruct by a natural biologic process
ratory. In these studies, Trisenox® inhibited
cal ed apoptosis. When activated, apop-
the growth of these cel s, induced apoptosis,
tosis programs cel s to destroy themselves.
and had anti-angiogenic activity.
n In APL cel s, Trisenox® may cause the leu-
The ability of Trisenox® to destroy can-
kemia cel s to dif erentiate partial y, and
cer cel s is enhanced when levels of a
8
9
compound cal ed glutathione are lowered in
the response was higher and longer lasting. A
cancer cel s. Because ascorbic acid (more
third study evaluated twice-weekly Trisenox®
commonly known as vitamin C) has this abil-
fol owed by a 3-week rest period at the same
ity, researchers have performed laboratory
and higher doses. High-dose corticosteroids
experiments in myeloma cel s and demon-
were added to the treatment regimen for
strated that Trisenox® activity was enhanced
patients whose disease progressed.
in combination with ascorbic acid, even in
triSenox® in Combination with
myeloma cel s from patients whose disease
other drugS
was resistant to other chemotherapy agents.
Trisenox® activity was also enhanced in
Because Trisenox® has shown activity in
laboratory studies in combination with dexa-
combination with other agents in the labora-
methasone or melphalan.
tory, several clinical studies are investigating
Trisenox® combination therapy. These studies
CLiniCaL StudieS of triSenox® in myeLoma
are summarized below.
All clinical studies of Trisenox® have been
trisenox® with ascorbic acid (Vitamin C)
in patients with relapsed or refractory
Because ascorbic acid enhanced the activity
myeloma. Trisenox® was studied as a single
of Trisenox® in myeloma cel s, it is being stud-
agent in a Phase I trial in a smal number of
ied in patients. A Phase I/I trial evaluated
patients. These patients received daily doses
two doses of Trisenox® plus ascorbic acid in
of Trisenox® for 2 months. Because of lim-
patient with relapsed or refractory myeloma.
ited responses and some serious side ef ects,
The Phase I portion of the trial is complete
another Phase I trial tested a higher, less fre-
and established the dose for the Phase I por-
quent dose of Trisenox®, administered 5 days
tion of the trial.
per week for two weeks with a 2-week rest
period (4-week cycle). In this smal group of
tad therapy: trisenox® with ascorbic acid and
patients with relapsed, refractory myeloma,
dexamethasone
The combination of Trisenox®, ascorbic acid,
and dexamethasone (known as TAD therapy)
has been studied in various regimens in sev-
eral Phase I studies. Some responses have
been seen with this combination.
trisenox®, ascorbic acid, dexamethasone,
and thalomid®
This combination was tested in a Phase I study.
Four of 13 evaluable patients responded
10
11
and the median progression-free survival has
a Phase I/I trial of safety and ef icacy as
not been reached at a median fol ow-up of
a conditioning regimen prior to autologous
9.5 months. Although the regimen was wel -
stem cel transplantation. There was no dif-
tolerated, 3 patients had abnormal blood
ference in response rates, progression-free
clot ing events, including 2 with deep vein
survival, or overal survival among the three
thrombosis (DVT) and one with a pulmonary
treatment groups. Treatment with Trisenox®
embolism (PE).
did not delay or inhibit stem cel engraftment
melphalan with trisenox® and ascorbic acid
and was wel tolerated.
In 10 patients, ascorbic acid and melphalan
trisenox® with Velcade® and ascorbic acid
with Trisenox® (a combination known as
Three dose levels of Velcade® were tested
MAC therapy) gave encouraging results,
in combination with Trisenox® and ascorbic
showing that the MAC regimen is active
acid. The combination was investigated
and very wel tolerated, with no serious side
in a Phase I/I trial, in which there were 6
ef ects. Al patients treated responded to
patients responding of 22 enrol ed, with
therapy, and 6/10 (60%) patients remained
more responses in the higher Velcade®
disease free for prolonged period, includ-
dose groups.
ing 2 patients responding for more than 1
year. Melphalan was discontinued after 36
what iS next for triSenox®?
weeks of treatment and patients received
Research is ongoing to evaluate Trisenox®
Trisenox® and ascorbic acid. These results
for the treatment of myeloma. Current and
have led to a larger Phase I study to further
future clinical trials wil continue to focus
evaluate the MAC regimen with the addition
on combining Trisenox® with other agents,
of corticosteroids for progressive disease.
including Velcade®, Thalomid®, melphalan,
Objective responses have been seen in 31
and dexamethasone. The goal of these trials
of 65 patients (48%) enrol ed, with a median
is to develop new treatment regimens that
duration of response of 12 months, median
improve the response of patients to therapy,
overal survival of 19 months, and median
maintaining or improving their quality and
progression-free survival of 7 months. A
length of life.
dif erent combination of ascorbic acid and
In addition to being evaluated in myelo-
melphalan with Trisenox® (a combination
ma, Trisenox® continues to be investigated
known as MAT therapy) has been tested in a
in other blood disorders, including sev-
smal number of patients.
eral forms of leukemia, lymphoma, and
The combination of high dose melphalan
myelodysplastic syndromes, as wel as solid
and ascorbic acid with one of two doses of
tumor cancers such as prostate cancer and
Trisenox® or without Trisenox® was tested in
melanoma.
12
13
important Safety information
What are the Possible Side Effects
n If you are pregnant or are planning to
of Trisenox®?
become pregnant, inform your doctor.
General y, most of the side ef ects associ-
Women of childbearing potential are
ated with Trisenox® are manageable and
advised to avoid pregnancy while taking
predictable. The most important side ef ects
Trisenox®. Laboratory studies indicate that
are described here. This is not a complete
Trisenox® is potential y harmful to develop-
ing fetuses.
list of side ef ects. Your doctor or nurse can
provide more information in greater detail
n You should not take Trisenox® if you are
about these and other possible side ef ects.
nursing. Because arsenic may be pres-
Although much of the clinical experience with
ent in excreted human milk, if you are
Trisenox® has been in patients with APL, over
breast-feeding, you are advised to discon-
1300 patients with multiple myeloma have
tinue either breast-feeding or Trisenox®
been treated with Trisenox®. The side ef ects
therapy.
seen in patients with myeloma are similar to
n If you have a documented hypersensitivity
those seen in patients with APL. However,
to arsenic or are intolerant of Trisenox®
increased reports of cytopenia, or decreased
therapy, you should not take Trisenox®.
numbers of cel s in the blood, have been
Three potential y serious side ef ects that have
observed in patients with myeloma treated
occurred in patients treated with Trisenox®
with Trisenox®.
are:
n APL dif erentiation syndrome
n Hyperleukocytosis
n QT interval prolongation
APL dif erentiation syndrome and hyperleuko-
cytosis have been seen primarily in patients
with APL, and may be uncommon in patients
with multiple myeloma.
aPL differentiation Syndrome
Symptoms of APL dif erentiation syndrome
include fever, sudden weight gain, dif icult
breathing, and accumulation of fluid in the
lungs, heart, and chest. You may be asked
to weigh yourself daily during the first few
14
15
weeks of treatment and to report right away
may be prescribed, since adequate levels
any increases in weight, which may indicate
of magnesium and potassium help prevent
fluid accumulation. You should inform your
heart rhythm changes.
physician if you experience any of these
Common side ef ects that may arise while
symptoms. This side ef ect is managed by
receiving Trisenox® include dizziness, light-
immediate treatment with high-dose cortico-
headedness, and low blood pressure. Should
steroids and diuretics.
these symptoms occur, the rate at which
hyPerLeukoCytoSiS
Trisenox® is infused may be altered.
Hyperleukocytosis is an unusual increase in
Other, less serious side ef ects that may occur
the number of white blood cel s. Your physi-
while receiving Trisenox® include:
cian wil monitor your blood to check for this
n Increased white cel counts
side ef ect..
n Nausea, vomiting, diarrhea, or
Qt interVaL ProLongation
abdominal pain
QT interval prolongation is an increase in
n Fatigue
the time it takes the heart to relax between
n Fluid retention (swel ing)
beats. This has the potential to cause fainting
n Hyperglycemia (abnormal y increased
or more serious side ef ects. Your physician
blood sugar levels)
wil monitor you using electrocardiograms
n Shortness of breath
(ECGs) during treatment to detect any chang-
n
es in your heart rhythm. Your blood may
Cough
be tested for low levels of magnesium or
n Rash or itching
potassium. Daily doses of these electrolytes
n Headaches
n Dizziness
Notify your doctor or nurse if you experience
any of the above symptoms.
Will Taking Other Drugs or
Medications Affect Trisenox®?
Inform your doctor of any other prescription
or over-the-counter medications, vitamins,
diet supplements, or herbal products you are
taking, as these or other compounds may
interact or interfere with Trisenox® treatment.
16
17
This is particularly important if you take
What Questions Should I Ask
heart medications or other medications that
My Healthcare Provider
may af ect your heartbeat, as these drugs
may adversely interact with Trisenox
about Trisenox®?
® and
increase the risk of potential y harmful irregu-
Questions you may want to ask your doctor
lar heartbeats.
or healthcare professional before receiving
How is Trisenox
Trisenox® include:
® Given?
n How often and how long wil I be taking
Trisenox® is given by intravenous (I.V.) infu-
Trisenox®?
sion over one to two hours. If low blood pres-
n What side ef ects may occur while I am
sure, light-headedness, or dizziness occurs
receiving Trisenox®?
when Trisenox® is first given, administration
n Wil Trisenox® af ect my daily life?
may be slowed down and extended over a
n Wil Trisenox® interfere with my other
four-hour period to al eviate these symptoms.
medications?
In almost al cases, Trisenox® can be given
on an outpatient basis.
n Is there anything I should avoid while
taking Trisenox®?
What is the Dose and Schedule
n Can you provide me with additional
for Trisenox®?
patient education information about
Trisenox®?
The most ef ective dose and schedule for
treating multiple myeloma with Trisenox® is
Where Can I Get More Information?
stil being determined in clinical trials, as are
Contact
the
International
Myeloma
the types and doses of other agents that may
Foundation (IMF) for additional information
be administered with Trisenox®.
about multiple myeloma and approved thera-
How Can I Receive Treatment
pies. Your doctor or healthcare provider may
with Trisenox
have writ en information available regarding
®?
Trisenox®. Additional information can be
At present, Trisenox® is available to patients
obtained by visiting the Cephalon Oncology
with multiple myeloma and other types of
Inc., website at www.CephalonOncology.
cancer (other than APL) who are wil ing to
com and www.TRISENOX.com.
participate in clinical trials. For more infor-
IMF hotline:
mation on how to enrol in a clinical trial,
USA & Canada only: 800-452-CURE (2873)
contact the IMF.
Elsewhere: 818-487-7455
IMF Web site: www.myeloma.org
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19
About the IMF
The IMF provides programs and services to
aid in the research, diagnosis, treatment,
"One person can make a dif erence,
and management of myeloma. The IMF
Two can make a miracle."
ensures that no one must brave the myeloma
Brian D. Novis
bat le alone.
IMF Founder
We care for patients today, while working
Myeloma is a lit le-known, complex, and
toward tomorrow's cure.
often misdiagnosed bone marrow cancer
that at acks and destroys bone. Myeloma
How Can the IMF Help You?
af ects approximately 75,000 to 100,000
Patient eduCation
people in the United States, with approxi-
information PaCkage
mately 20,000 new cases diagnosed each
Our free IMF InfoPack provides comprehensive
year. While there is presently no known cure
information about myeloma, treatment options,
for myeloma, doctors have many approach-
disease management, and IMF services. It
es to help myeloma patients live bet er and
includes our acclaimed Patient Handbook.
longer.
internet aCCeSS
The International Myeloma Foundation (IMF)
Log on to www.myeloma.org for 24-hour
access to information about myeloma, the IMF,
was founded in 1990 by Brian and Susie
education, and support programs.
Novis shortly after Brian's myeloma diagno-
sis at the age of 33. It was Brian's dream that
onLine myeLoma forum
future patients would have easy access to
Join the IMF Internet Discussion Group at
www.myeloma.org/listserve.html to share your
medical information and emotional support
thoughts and experiences.
throughout their bat le with myeloma. He
established the IMF with the 3 goals of treat-
myeLoma minute
Subscribe to this free weekly email news-
ment, education, and research. He sought
let er for up-to-the-minute information about
to provide a broad spectrum of services for
myeloma.
patients, their families, friends, and health
care providers. Although Brian died 4 years
Patient & famiLy SeminarS
Meet with leading experts in myeloma treat-
after his initial diagnosis, his dream didn't.
ment to learn more about recent advances in
Today the IMF reaches out to an international
therapy and research.
membership of more than 150,000. The IMF
was the first organization dedicated solely to
myeLoma matrix
On our website and in print, this document is a
myeloma, and today it remains the largest.
comprehensive guide to drugs in development
for myeloma.
20
21
myeLoma today newSLetter
Glossary
Our quarterly newslet er is available free of
charge by subscription.
Acute promyelocytic leukemia (APL): A subtype of the
cancer known as acute myeloid leukemia (AML).
SuPPort
APL is characterized by abnormal promyelocytes,
myeLoma hotLine: 800-452-Cure (2873)
a type of white blood cel . When APL occurs, these
Toll-free throughout the United States and
abnormal promyelocytes accumulate in the bone
Canada, the IMF Hotline is staf ed by trained
marrow and peripheral blood and replace normal
information specialists and is in frequent inter-
blood cel s.
action with members of our Scientific Advisory
Alkylating agent: A chemotherapy agent that prevents
Board.
the growth and division of new cancer cel s by inhibit-
ing their ability to replicate DNA.
SuPPort grouPS
A worldwide network of more than 100
Anemia: A low level of red blood cel s in the blood-
myeloma support groups; these groups hold
stream.
regular meetings for members of the myeloma
Angiogenesis: The growth and formation of new blood
community. The IMF conducts annual retreats
vessels, often stimulated by cancer cel s to obtain
for myeloma support group leaders.
nutrients.
reSearCh
Anti-angiogenic activity: Ability to inhibit new blood
vessel development.
bank on a Cure®
This DNA bank wil provide genetic data
Antibody: A protein produced by some of the body's
research for new drug development.
white blood cel s that helps fight infection.
the internationaL Staging SyStem (iSS)
APL differentiation syndrome: A potential y serious
This updated staging system for myeloma
side ef ect of which is characterized by fever,
enhances physicians' ability to select the most
sudden weight gain, dif icult breathing, and fluid
appropriate treatment for each patient.
accumulation.
Apoptosis: The programmed death of cel s through
reSearCh grantS
biologic processes. Although it occurs natural y and
Leading the world in col aborative research
normal y in several biologic functions, apoptosis can
and achieving extraordinary results, the IMF
be stimulated in tumor cel s by certain cancer drugs.
Grant Program supports both junior and senior
researchers working on a broad spectrum of
Ascorbic acid: Vitamin C; required for healthy teeth
and gums, helps in the absorption of iron, aids in
projects. The IMF has at racted many young
the maintenance of normal connective tissue, and
investigators into the field of myeloma; they
promotes wound healing. It also is an antioxidant
have remained in the field; and are actively
that contributes to a healthy immune system. It is
pursuing a cure for this disease.
being tested in some clinical trials in combination
with Trisenox®.
22
23
Bone marrow: A soft, spongy tissue found in most
Immune system: The system of white blood cel s and
large bones that produces red and white blood cel s
their products that helps the body resist infection and
and platelets.
some cancers.
Chemotherapy: Use of chemicals to treat or control
Immunoglobulin: An antibody.
cancer.
Intravenous (I.V.) infusion: Delivery of a drug or fluid
Chronic myelogenous leukemia (CML): A slowly progress-
into the body using a needle inserted into a vein.
ing blood disorder in which too many white blood
cel s are made in the bone marrow, eventual y replac-
Leukemia: Cancer arising from one of the blood-form-
ing normal white blood cel s.
ing cel s in the bone marrow.
Corticosteroids: A group of steroid hormones that
Lymphoma: Cancer arising from certain cel s of the
includes dexamethasone; used to treat myeloma
immune system.
and other cancers, as wel as problems arising from
Lysis (lytic): Dissolution or destruction of cel s.
treatment.
Malignant: Cancerous.
Cytopenia: Abnormal y decreased numbers of blood
cel s.
Melphalan: An anticancer drug that belongs to a class
of drugs cal ed alkylating agents. Alkylating agents
Dexamethasone: A synthetic steroid similar to steroid
work by damaging DNA and inducing the death of
hormones produced natural y in the adrenal gland.
tumor cel s.
Dexamethasone is used to treat leukemia, lymphoma,
and certain problems caused by other cancers and
Mitochondria: Smal structures within cel s that provide
their treatment.
energy.
Differentiation: Process by which cel s become more
Monoclonal protein (M protein): An abnormal protein
mature and less likely to continue to divide.
produced by myeloma cel s that accumulates in and
damages bone and bone marrow. A high level of M
Diuretics: Drugs that rid the body of excess fluid.
protein indicates that myeloma cel s are present in
Deep vein thrombosis (DVT): Blood clot that originates
large numbers.
in deep veins, usual y in the pelvis or legs, that may
Multiple myeloma: A cancer arising from the plasma
move to other areas of the body, sometimes with fatal
cel s in the bone marrow. The plasma cel s in patients
consequences.
with multiple myeloma form abnormal antibodies,
Electrocardiogram (ECG): A test used to evaluate heart
possibly damaging the bone, bone marrow, and
rhythm, in which electric conductors are placed on the
other organs.
body to produce an electrical reading of the heart's
Myelodysplastic syndromes (MDS): A group of bone
contractions.
marrow neoplastic diseases in which not enough
Electrolytes: Various chemicals in the blood including
healthy blood cel s are produced. MDS have some
magnesium and potassium.
features of acute myeloid leukemias.
Hyperglycemia: Abnormal y increased blood sugar
Neoplasm: Cancer.
levels.
Plasma cell: A type of white blood cel that produces
Hyperleukocytosis: Abnormal y increased levels of
antibodies.
white blood cel s.
24
25
Plasmacytoma: A tumor made up of cancerous plasma
cel s.
Platelet: An element in the blood that helps with
clot ing, which in turn helps repair damaged blood
vessels.
Pulmonary embolism (PE): Blood clot from another part
of the body that is transported to the lungs in the
blood, and may be fatal.
QT interval prolongation: An increase in the amount of
time it takes the heart to relax in between beats.
Red blood cell: A blood cel that carries oxygen from
the lungs throughout the body.
Side effect: An ef ect caused by treatment with a drug.
The term usual y refers to an unwanted ef ect, but
some side ef ects may be beneficial.
Stage I (low cell mass): Early myeloma disease.
Stage II (intermediate cell mass): Stage of myeloma
disease intermediate between stages I and I I.
Stage III (high cell mass): More advanced myeloma
disease.
Trisenox® (arsenic trioxide): An anticancer drug that is
used in the treatment of several types of leukemia and
other types of cancer. A derivative of natural y occur-
ring arsenic, Trisenox® can reduce or eliminate can-
cer cel s from patients through several mechanisms.
White blood cel : A cel made by the bone marrow that
helps fight infection and/or disease.
26