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Respir Med. 2013 Sep;107(9):1423-30. doi: 10.1016/j.rmed.2013.06.012. Epub 2013 Jul 5.

Effect of therapeutic arsenic exposure on pulmonary function.

Author information

1
Division of Respiratory Medicine, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region. jhocm@hku.hk

Abstract

AIM:

Arsenic-contaminated drinking water has been associated with respiratory diseases and lung function impairment. Oral arsenic trioxide (ATO) is a standard treatment for acute promyelocytic leukaemia. This study aimed to explore the effect of therapeutic exposure to arsenic on lung function.

PATIENTS AND METHOD:

This was a case-control cross-sectional study on patients with haematological malignancies with or without exposure to ATO. Full lung function tests and serum Clara cell protein 16 (CC16) were measured.

RESULTS:

There were 57 cases (arsenic exposed) and 57 matched controls (arsenic non-exposed) recruited. Among cases, the median duration of ATO exposure was 519 (194-1259) days. The mean FEV(1)/FVC ratio, FEV(1) (% predicted), and RV/TLC (%), as well as % subjects with FEV(1)/FVC below lower limits of normal (LLN), were similar in the two groups with or without arsenic exposure. However the mean TLC (% predicted) and DLCO/VA were significantly higher in arsenic-exposed versus non-exposed group (p = 0.01 and p = 0.008 respectively). There were mildly reduced FEV(1)/FVC ratio and FEF(25-75) (% predicted), largely within normal limits, among high level arsenic exposure compared with non-exposure (p = 0.01 and p = 0.05 respectively). Serum CC16 was comparable among both arsenic exposed and non-exposed groups.

CONCLUSION:

Therapeutic use of oral ATO for a median of around 1.5 years was not associated with clinically significant lung function impairment.

KEYWORDS:

APL; ATO; Arsenic trioxide; CC16; Clara cell protein; Clara cell protein 16; DLCO; DLCO/VA; FEF(25–75); FEV(1); FVC; IQR; Leukaemia; Lung function; RV; SD; TLC; acute promyelocytic leukaemia; arsenic trioxide; diffusing capacity corrected for haemoglobin; forced expiratory flow between 25% and 75% of FVC; forced expiratory volume in one second; forced vital capacity; interquartile range; residual volume; standard deviation; total lung capacity; transfer factor

PMID:
23835189
DOI:
10.1016/j.rmed.2013.06.012
[Indexed for MEDLINE]
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