Incidence rate and relevant factors of QT interval prolongation induced by arsenic trioxide in therapy of acute promyelocytic leukemia

Abstract

Objective To analyze the incidence rate and time phases of corrected-QT interval(QTc) prolongation and to explore relevant factors which lead to QTc prolongation during acute promyelocytic leukemia (APL) treatments. Method A retrospective analysis of APL patients who received arsenic trioxide(ATO) standard treatments with complete data in the Hematology Department of the First Hospital of Dalian Medical University from May 2006 to Feb.2017 was conducted.The basic information, biochemical indicators and electrocardiogram data of patients were collected and analyzed statistically. Results Sixty-one patients received 252 times ATO treatments.The incidence rate of QTc prolongation in the treatments was 23.8% and QTc prolonged (20.38±7.11) ms after drug use(P<0.05). The QTc prolongation incidence rate was 21.3% in the patients with hemoglobin(HB)≥90 g/L, compared with 35.1% in patients with HB<90 g/L.In the induction and consolidation therapies, the incidence rate of HB<90 g/L was 59.7% and 4.7%, with QTc prolongation incidence rate 46.3% and 12.9%, respectively.The QTc prolongation incidence rate was 21.4% in the patients with normal level lactate dehydrogenase (LDH), compared with 42.9% in the patients with higher-level LDH.The ventricular rate before drug-use had correlation with QTc, the correlation coefficient was 0.152(P=0.015). The ventricular rate after drug use still had correlation with QTc, the correlation coefficient was 0.230(P=0.000). Conclusion When using ATO, moderate-severe anemia patients were more prone to QTc prolongation.This phenomenon was more prominent during the induction of therapy.High-level LDH patients were with high QTc prolongation incidence rate.The ventricular rate was correlated with QTc during medication.QTc prolongation could be controlled by lowering the ventricular rate. Key words: Hemoglobins; Arsenic trioxide; QT interval