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5 December 2000 | Volume 133 Issue 11 | Pages 881-885
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.
Author and Article Information
From Hamamatsu University School of Medicine, Hamamatsu, and Aichi Cancer Center Hospital, Nagoya, Japan.
Grant Support: By a Grant-in-Aid for Cancer Research (No. 9-2) of the Japanese Ministry of Health and Welfare.
Requests for Single Reprints: Kazunori Ohnishi, MD, Department of Medicine III, Hamamatsu University School of Medicine, 3600 Handa-cho, Hamamatsu 431-3192, Japan; e-mail, kohnishi{at}hama-med.ac.jp.
Current Author Addresses: Drs. Ohnishi, Yoshida, Shigeno, Nakamura, Fujisawa, Naito, Shinjo, Fujita, Matsui, Takeshita, Sugiyama, Satoh, and Terada: Department of Medicine III, Hamamatsu University School of Medicine, 3600 Handa-cho, Hamamatsu 431-3192, Japan.
Dr. Ohno: Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusaku, Nagoya 464-8681, Japan.
Author Contributions: Conception and design: K. Ohnishi, R. Ohno.
Analysis and interpretation of the data: K. Ohnishi, S. Sugiyama, H. Satoh, H. Terada, R. Ohno.
Drafting of the article: K. Ohnishi.
Critical revision of the article for important intellectual content: K. Ohnishi, S. Sugiyama, H. Satoh, H. Terada, R. Ohno.
Final approval of the article: K. Ohnishi, H. Yoshida, K. Shigeno, S. Nakamura, S. Fujisawa, K. Naito, K. Shinjo, Y. Fujita, H. Matsui, A. Takeshita, R. Ohno.
Provision of study materials or patients: K. Ohnishi, H. Yoshida, K. Shigeno, S. Nakamura, S. Fujisawa, K. Naito, K. Shinjo, Y. Fujita, H. Matsui, A. Takeshita, R. Ohno.
Obtaining of funding: R. Ohno.
Administrative, technical, or logistic support: R. Ohno.
Collection and assembly of data: K. Ohnishi, H. Yoshida, K. Shigeno, S. Nakamura, S. Fujisawa, K. Naito, K. Shinjo, Y. Fujita, H. Matsui, A. Takeshita. BRIEF COMMUNICATION
Prolongation of the QT Interval and Ventricular Tachycardia in Patients Treated with Arsenic Trioxide for Acute Promyelocytic Leukemia
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