Document Detail

Effects of oral arsenic trioxide therapy on QT intervals in patients with acute promyelocytic leukemia: implications for long-term cardiac safety.
MedLine Citation:
PMID:  16514059     Owner:  NLM     Status:  MEDLINE    
Ventricular tachyarrhythmias may occur during intravenous arsenic trioxide (As2O3). This has not happened during oral As2O3. Sixteen patients were studied by electrocardiography and 24-hour Holter monitoring at baseline, during and after oral As2O3 (As2O3-ON, As2O3-OFF). QT and corrected QT (QTc) were significantly longer during As2O3-ON than in As2O3-OFF, but QT and QTc dispersions were comparable. The patients' 24-hour heart rates were higher during As2O3-ON than in As2O3-OFF. QTc intervals at each hour were longer during As2O3-ON than in As2O3-OFF. However, QTc prolongation of more than 30 milliseconds only occurred at one time point (2 hours) after oral As2O3, resulting in QTc of more than 500 milliseconds in 3 of 16 patients, all within 4 hours of oral As2O3. Although the standard deviation of normal RR interval was lower during As2O3-ON, ratios of low frequency to high frequency power for As2O3-ON and As2O3-OFF were comparable. No ventricular proarrhythmias were observed. These observations, due to the lower peak plasma arsenic reached during oral As2O3, may explain the relative cardiac safety of oral As2O3.
Chung-Wah Siu; Wing-Yan Au; Cindy Yung; Cyrus R Kumana; Chu-Pak Lau; Yok-Lam Kwong; Hung-Fat Tse
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2006-03-02
Journal Detail:
Title:  Blood     Volume:  108     ISSN:  0006-4971     ISO Abbreviation:  Blood     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-06-22     Completed Date:  2007-08-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  United States    
Other Details:
Languages:  eng     Pagination:  103-6     Citation Subset:  AIM; IM    
Divisions of Cardiology, Hematology, and Clinical Pharmacology, Department of Medicine, University of Hong Kong, Hong Kong.
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MeSH Terms
Administration, Oral
Arsenicals / administration & dosage*,  blood,  therapeutic use
Dose-Response Relationship, Drug
Drug Toxicity*
Electrocardiography, Ambulatory
Heart Conduction System / drug effects*,  physiopathology
Heart Rate / drug effects
Leukemia, Promyelocytic, Acute / diagnosis*,  drug therapy*
Middle Aged
Oxides / administration & dosage*,  blood,  therapeutic use
Treatment Outcome
Reg. No./Substance:
0/Arsenicals; 0/Oxides; 1327-53-3/arsenic trioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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