Arsenic-induced torsades de pointes in multiple myeloma

Arsenic trioxide (AsO3) is used as a chemotherapeutic agent for acute promyelocytic leukemia. It prolongs the QT and causes torsades de pointes (TdP). AsO3 has also recently been used for refractory multiple myeloma because it inhibits myleoma cell proliferation by depolarizing the mitochondrial tra...

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Bibliographic Details
Published in:Clinical toxicology (Philadelphia, Pa.) Pa.), 2006-04, Vol.44 (4), p.576-576
Main Authors: Halcomb, SE, Howland, MA, Huffman, R S, Nelson, L S, Barbey, J T, Rao, R B
Format: Article
Language:English
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Summary:Arsenic trioxide (AsO3) is used as a chemotherapeutic agent for acute promyelocytic leukemia. It prolongs the QT and causes torsades de pointes (TdP). AsO3 has also recently been used for refractory multiple myeloma because it inhibits myleoma cell proliferation by depolarizing the mitochondrial transmembrane potential. This ultimately leads to caspase activation and apoptosis of myeloma cells. When AsO3 is used for multiple myeloma it may also may prolong the QT and increase the risk of TdP. Although a recent study showed that QT prolongation occurred with a half-life of 6+/-2 days in patients receiving arsenic infusions, the onset and duration of TdP remains poorly defined. We report a case of recurrent TdP nine days after discontinuation of AsOS.
ISSN:1556-3650