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Qinghuang powder (Qinghuang San) is a traditional Chinese medicine (TCM) formula primarily composed of Realgar (containing arsenic disulfide) and Indigo Naturalis (containing indirubin). It was developed and is extensively utilized by Xiyuan Hospital of the China Academy of Chinese Medical Sciences for the treatment of myelodysplastic syndrome (MDS) and certain types of leukemia. The therapeutic mechanism is largely attributed to the arsenic disulfide component, which induces apoptosis and differentiation in malignant myeloid clones, and indirubin, which acts as a cyclin-dependent kinase (CDK) and glycogen synthase kinase 3 beta (GSK3B) inhibitor to suppress cell proliferation. It is typically administered as an oral powder and is often used as a hospital-made preparation in China for patients with low-to-intermediate risk MDS.
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