Two cases of acute promyelocytic leukemia complicated by torsade de pointes during arsenic trioxide therapy
Two cases of acute promyelocytic leukemia complicated by torsade de pointes during arsenic trioxide therapy
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DOI：
10.1532/ijh97.05056
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发表时间：
2006-05-01
影响因子：
2.1
通讯作者：
Ohnishi, Kazunori
中科院分区：
文献类型：
--
作者：
Naito, Kensuke;Kobayashi, Miki;Ohnishi, Kazunori
我们描述了2例急性早幼粒细胞白血病(APL)患者，在三氧化二砷治疗期间出现尖端扭体(TDP)。患者1是一名23岁的女性，患有第二次复发的APL。室性早搏发生在治疗第27天，TDP发作发生在第28天。患者2是一名51岁的女性，患有第二次复发的急性早幼粒细胞白血病，由于之前接受了蒽环类药物治疗，她有心肌病。TDP发生于治疗第17天。已知三氧化二砷会引起心电图异常，如室性心动过速和QT间期延长。患者1服用氟康唑作为伴随药物。例2有心肌病和低钾血症。在三氧化二砷治疗期间需要谨慎处理，因为这种治疗延长了OT间期，可能导致TDP发作。
We describe 2 patients with acute promyelocytic leukemia (APL) in whom torsade de pointes (TdP) developed during treatment with arsenic trioxide. Patient 1 was a 23-year-old woman with second-relapse APL. Ventricular premature beat bigeminy developed on day 27 of treatment, and episodes of TdP developed on day 28. Patient 2 was a 51-year-old woman with second-relapse APL who had cardiomyopathy due to prior anthracycline treatment. TdP developed on day 17 of treatment. Arsenic trioxide is known to cause electrocardiographic abnormalities, such as ventricular tachycardia and prolongation of QT interval. Patient 1 was given fluconazole as a concomitant drug. Patient 2 had cardiomyopathy and hypokalemia. Careful management is needed during arsenic trioxide therapy because this treatment prolongs the OT interval, possibly inducing episodes of TdP.