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Ann Intern Med. 2000 Dec 5;133(11):881-5.

Prolongation of the QT interval and ventricular tachycardia in patients treated with arsenic trioxide for acute promyelocytic leukemia.

Author information

1
Department of Medicine III, Hamamatsu University School of Medicine, 3600 Handa-cho, Hamamatsu 431-3192, Japan. kohnishi@hama-med.ac.jp

Abstract

BACKGROUND:

Recently, arsenic trioxide has increasingly been used for relapsed acute promyelocytic leukemia. However, it is known to have several adverse effects, including acute cardiac toxicities.

OBJECTIVE:

To determine cardiac toxicities resulting from arsenic trioxide therapy in patients with relapsed or refractory acute promyelocytic leukemia.

DESIGN:

Phase II clinical prospective cohort study.

SETTING:

A university hospital in Hamamatsu, Japan.

PATIENTS:

8 patients with relapsed acute promyelocytic leukemia.

INTERVENTION:

Arsenic trioxide, 0.15 mg/kg of body weight, administered daily by 2-hour infusion for a maximum of 60 days.

MEASUREMENTS:

Continuous monitoring with ambulatory electrocardiography.

RESULTS:

Five patients (63%) achieved complete remission. During induction therapy with arsenic trioxide, prolonged QT intervals were observed in all patients. Ventricular premature contractions were noticed during 8 of 12 courses of therapy. Four patients developed nonsustained ventricular tachycardia and required treatment with antiarrhythmic agents.

CONCLUSIONS:

Cardiac toxicity occurs during arsenic trioxide therapy in patients with acute promyelocytic leukemia. Such patients should be monitored for prolonged QT intervals and ventricular arrhythmia.

PMID:
11103058
[Indexed for MEDLINE]

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