Inclusion Criteria

INCLUSION CRITERIA

1. APML diagnosis based upon morphological, histochemical, and/or flow cytometric
criteria, confirmed upon review by a central, study-designated hematologic
pathologist;

OR

any relapsed acute leukemia bearing a t(15:17) translocation or variant APML
translocations involving the retinoic acid receptor alpha gene on chromosome 15q22,
based on cytogenetics or PCR.

2. disease in first or subsequent relapse, following standard induction and
consolidation chemotherapy (with all-trans retinoic acid) and/or allogeneic bone
marrow/stem cell transplantation;

OR

failure to achieve initial complete remission with ATRA and standard chemotherapy.

EXCLUSION CRITERIA

1. Availability of a fully HLA-matched sibling donor for patients otherwise felt to be
candidates for allogeneic bone marrow/stem cell transplantation; patients with only a
partially HLA-matched sibling or matched unrelated donor will remain eligible for
study entry.

2. pregnancy.

3. Patients with significantly impaired left ventricular ejection fraction (<40%) will
be ineligible for the study.

Patients with renal failure and a creatinine clearance of less than 25 ml/min or requiring
hemodialysis will be ineligible for the study. Otherwise, there are no rigid exclusion
criteria based upon age, performance status, or co-morbidity. Decisions regarding
enrollment of patients for whom these factors may be relevant will be individualized and
left to the discretion of the investigators. Central venous access will be required for
all patients. Patients of child-bearing potential must agree to use contraception during
sexual intercourse while undergoing treatment with arsenic trioxide.