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Prolongation of the QT Interval and Ventricular Tachycardia in Patients Treated with Arsenic Trioxide for Acute Promyelocytic Leukemia
- Kazunori Ohnishi, MD;
- Hitoshi Yoshida, MD;
- Kazuyuki Shigeno, MD;
- Satoki Nakamura, MD;
- Shinya Fujisawa, MD;
- Kensuke Naito, MD;
- Kaori Shinjo, MD;
- Yota Fujita, MD;
- Hirotaka Matsui, MD;
- Akihiro Takeshita, MD;
- Shiho Sugiyama, MD;
- Hiroshi Satoh, MD;
- Hajime Terada, MD; and
- Ryuzo Ohno, MD
- From Hamamatsu University School of Medicine, Hamamatsu, and Aichi Cancer Center Hospital, Nagoya, Japan.
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.
- Long QT syndrome
- Leukemia, promyelocytic, acute
- Neoplasm recurrence, local
- Arsenic trioxide
- Tachycardia, ventricular
Article and Author Information
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Grant Support: By a Grant-in-Aid for Cancer Research (No. 9-2) of the Japanese Ministry of Health and Welfare.
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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.
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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.
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Dr. Ohno: Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusaku, Nagoya 464-8681, Japan.
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Author Contributions: Conception and design: K. Ohnishi, R. Ohno.
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Analysis and interpretation of the data: K. Ohnishi, S. Sugiyama, H. Satoh, H. Terada, R. Ohno.
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Drafting of the article: K. Ohnishi.
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Critical revision of the article for important intellectual content: K. Ohnishi, S. Sugiyama, H. Satoh, H. Terada, R. Ohno.
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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.
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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.
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Obtaining of funding: R. Ohno.
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Administrative, technical, or logistic support: R. Ohno.
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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.
- Copyright ©2004 by the American College of Physicians
