※ 引述《lepputte (华英成秀)》之铭言：
: 2005年的review我帮你标黄的，
: 是要告诉你砷剂最早在用在治疗癌症，是从中医那边绕进西医的。
: 结果你质疑说那篇太旧......
: 你有注意到那个开头的24篇参考文献是
: Science, Blood, NEJM....
: 如果你嫌它旧，keyword都有了，其实你应该也有能力查新的，
: 叫我一个中医不停地上pubmed查英文期刊给你
: 我真心觉得累。
专门回一篇砒霜/三氧化二砷的历史跟你说明
因为你写的太奇怪，中医理论没有癌症或白血病的概念，怎么可能会有用砒霜治疗癌症/
白血病的开端
于是我就查了一下，查到一些史料，其中一篇是在American society of hematology美国
血液科期刊一位读者给编辑的回信
Delicious Poison: Arsenic Trioxide for the Treatment of Leukemia
Y.L. Kwong, D. Todd
Blood (1997) 89 (9): 3487.
To the Editor:
Lately, arsenic trioxide (As2O3 ) has been described in the treatment of acute
myeloid leukemia. Experiments in vitro showed that As2O3 induced the acute pr
omyelocytic leukemia (APL) cell line NB4 to downregulate bcl-2 expression, as
well as to undergo apoptosis. Clinically efficacy has been shown in 14 of 15 p
atients with relapsed APL, where the use of intravenous As2O3 at a dose of 10
mg/d for 4 to 9 weeks resulted in complete morphologic remission without assoc
iated bone marrow suppression. In these cases, partial differentiation of the
APL cells and downregulation of the fusion protein PML/RARα could also be sho
wn, which might account for the pharmacologic action of the drug.
Arsenic has been known to be poisonous for centuries. Medicinal use of arsenic
began in the 15th century. In the 18th century, Dr Thomas Fowler developed a
solution preparation of As2O3 in potassium bicarbonate (1% wt/vol), known gene
rally as Fowler's solution, which was used empirically for the treatment of a
variety of infectious and malignant diseases. The effect of Fowler's solution
on the reduction of white cells in two normal people and one patient with “l
eucocythemia” studied at Boston City Hospital, MA was first described in 1878
.
This lead to the use of As2O3 for the treatment of leukemia, until the advent
of radiotherapy caused a decline in its clinical application. Its popularity
waxed again when Forkner and Scott, also at Boston City Hospital, described ni
ne of 10 patients with chronic myeloid leukemia (CML) who responded to As2O3 t
reatment. These results were subsequently confirmed by other reports, so that
As2O3 was considered next to irradiation as the most effective treatment of CM
L before the development of modern chemotherapy. Clinical improvement of the l
eukemia, including the control of fever, reduction of white cell count, amelio
ration of anemia and decrease in the size of spleen, could often be achieved.
Sometimes, a remission might be maintained for a long period. As expected, tox
ic side effects were observed in the majority of patients given long-term As2O
3 , including skin pigmentation and keratosis, cirrhosis, polyneuritis, and ga
strointestinal problems. In this department, As2O3 was used by hematologists i
n the 1950's for the treatment of a variety of leukemias. Figure 1 shows the t
ypical course of a patient treated with As2O3 for CML in chronic phase. As As2
O3 appeared to be effective for leukemias of different morphologic types, thea
ction was probably related to an intrinsic toxicity of arsenic to marrow cells
.
后面还有一个个案讨论跟药物几转讨论，总之三氧化二砷在西方从15世纪就有了，到了18
世纪，Dr Thomas Fowler用三氧化二砷跟碳酸氢钾溶液调配出Fowler’s solution，这个
福肋溶液会经验性拿来治疗感染疾病跟恶性疾病，后来在波士顿医院有医师报导关于三氧
化二砷在白血病(还包括CML)的效果。
中途查了APL的发展史，是在1957年：APL was first described in 1957 by the Norweg
ian hematologist Leif Hillestad[1]
然后我就去查这个福肋溶液跟“砷治疗”，有关历史上的治疗，写说拿来治疗疟疾、梅毒
和非洲锥虫，里面也有写到中国研究三氧化二砷在APL的治疗，最后是美国进行RCT被FDA
认证为APL治疗之一[2,3]
总结：砒霜/三氧化二砷拿来治疗血癌是西方有、两百年以前就开始有的，拿砒霜/三氧化
二砷治疗白血病不是中国开始的，中医也没有血球、白血病概念，而且是西医先有AML分
型和APL研究成果。说拿砒霜治疗血癌是由中医导入有点牵强。
Reference:
1. Thomas, X. Acute Promyelocytic Leukemia: A History over 60 Years—From the
Most Malignant to the most Curable Form of Acute Leukemia. Oncol Ther 7, 33–6
5 (2019). https://doi.org/10.1007/s40487-018-0091-5
2. Antman KH. Introduction: the history of arsenic trioxide in cancer therapy.
Oncologist. 2001;6 Suppl 2:1-2. doi: 10.1634/theoncologist.6-suppl_2-1. PMID:
11331433.
3. Ho D, Lowenstein EJ. Fowler's Solution and the Evolution of the Use of Arse
nic in Modern Medicine. Skinmed. 2016 Aug 1;14(4):287-289. PMID: 27784519.