Ann Hematol (2015) 94:501–503 DOI 10.1007/s00277-014-2174-1
LETTER TO THE EDITOR
Torsade de Pointes during oral arsenic trioxide therapy for acute promyelocytic leukemia in a patient with heart failure Jo Jo Hai & Harinder Gill & Hung-Fat Tse & Cyrus R. Kumana & Yok-Lam Kwong & Chung-Wah Siu
Received: 21 May 2014 / Accepted: 18 July 2014 / Published online: 1 August 2014 # Springer-Verlag Berlin Heidelberg 2014
Dear Editor, Intravenous arsenic trioxide (As2O3) is highly effective for the treatment of newly diagnosed and relapsed acute promyelocytic leukemia [1, 2], yet the high rate of significant corrected QT (QTc) prolongation and risk of ventricular arrhythmias mandates standard 12-lead and continuous electrocardiographic (ECG) monitoring during treatment [3, 4]. Earlier studies have shown that oral As2O3 has similar bioavailability but less cardiotoxicity, making it an attractive alternative to the intravenous drug [5, 6]. Nevertheless, data were mainly based on patients with structurally normal hearts, while its side-effect profile on those with underlying heart diseases remains undefined. Here, we present a patient with dilated cardiomyopathy who developed multiple arrhythmias during treatment with oral As2O3 therapy for acute promyelocytic leukemia.