Please wait a minute...
Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

邮发代号 80-967

2019 Impact Factor: 3.421

Frontiers of Medicine  2017, Vol. 11 Issue (2): 284-286   https://doi.org/10.1007/s11684-017-0514-y
  本期目录
Arsenic trioxide induced rhabdomyolysis, a rare but severe side effect, in an APL patient: a case report
Haiyan He, Ran An, Jian Hou, Weijun Fu()
Myeloma and Lymphoma Center, Department of Hematology, Changzheng Hospital, Shanghai 200003, China
 全文: PDF(71 KB)   HTML
Abstract

Arsenic trioxide (ATO), a component of the traditional Chinese medicine arsenic sublimate, promotes apoptosis and induces leukemic cell differentiation. Combined with all-trans-retinotic acid (ATRA), ATO has become the first-line induction therapy in treating acute promyelocytic leukemia (APL). The most common side effects of ATO include hepatotoxicity, gastrointestinal symptoms, water-sodium retention, and nervous system damage. In this report, we present a rare side effect, rhabdomyolysis, in a 68-year-old female APL patient who was treated with ATO. After taking 10 mg ATO daily for 6 days, she presented shortness of breath, myodynia, elevated creatine kinase, and acute renal insufficiency. This report describes the first case of ATO-induced rhabdomyolysis.

Key wordsarsenic trioxide    APL    rhabdomyolysis
收稿日期: 2016-07-19      出版日期: 2017-06-01
Corresponding Author(s): Weijun Fu   
 引用本文:   
. [J]. Frontiers of Medicine, 2017, 11(2): 284-286.
Haiyan He, Ran An, Jian Hou, Weijun Fu. Arsenic trioxide induced rhabdomyolysis, a rare but severe side effect, in an APL patient: a case report. Front. Med., 2017, 11(2): 284-286.
 链接本文:  
https://academic.hep.com.cn/fmd/CN/10.1007/s11684-017-0514-y
https://academic.hep.com.cn/fmd/CN/Y2017/V11/I2/284
1st day (ATO plus ?ARTA started)7th day8th day (ATO plus ATRA stopped)9th day10th day11th day21st day ?(3 weeks after ?single ARTA)
WBC (× 103/μl)0.89.78.112.719.824.910.6
Hb (g/L)98928264606081
Platelets ( × 109/L)4026893621203
Creatinine kinase (U/L)160562638150741810420
CK-MM (U/L)14947850713513728214
CK-MB (U/L)118413115646226
Creatinine (μmol/L)70151295239194145105
ALT (U/L)40495540272114
AST (U/L)2645623481401414
Myoglobin (ng/ml)65.5937.551716610543.650.4
LDH (U/L)1103820588531311856833319
cTnT (ng/ml)0.074.0513.75.363.90.190.01
Tab.1  
1 Chen Z, Chen SJ. RARA and PML genes in acute promyelocytic leukemia. Leuk Lymphoma 1992; 8(4-5): 253–260
https://doi.org/10.3109/10428199209051004 pmid: 1337847
2 Zhang TD, Chen GQ, Wang ZG, Wang ZY, Chen SJ, Chen Z. Arsenic trioxide, a therapeutic agent for APL. Oncogene 2001; 20(49): 7146–7153
https://doi.org/10.1038/sj.onc.1204762 pmid: 11704843
3 Soignet SL, Frankel SR, Douer D, Tallman MS, Kantarjian H, Calleja E, Stone RM, Kalaycio M, Scheinberg DA, Steinherz P, Sievers EL, Coutré S, Dahlberg S, Ellison R, Warrell RP Jr. United States multicenter study of arsenic trioxide in relapsed acute promyelocytic leukemia. J Clin Oncol 2001; 19(18): 3852–3860
pmid: 11559723
4 Estey E, Garcia-Manero G, Ferrajoli A, Faderl S, Verstovsek S, Jones D, Kantarjian H. Use of all-trans retinoic acid plus arsenic trioxide as an alternative to chemotherapy in untreated acute promyelocytic leukemia. Blood 2006; 107(9): 3469–3473
https://doi.org/10.1182/blood-2005-10-4006 pmid: 16373661
5 Ghavamzadeh A, Alimoghaddam K, Ghaffari SH, Rostami S, Jahani M, Hosseini R, Mossavi A, Baybordi E, Khodabadeh A, Iravani M, Bahar B, Mortazavi Y, Totonchi M, Aghdami N. Treatment of acute promyelocytic leukemia with arsenic trioxide without ATRA and/or chemotherapy. Ann Oncol 2006; 17(1): 131–134 
https://doi.org/10.1093/annonc/mdj019 pmid: 16227315 
6 Fanton L, Duperret S, Guillaumée F, Miras A, Vallon JJ, Malicier D. Fatal rhabdomyolysis in arsenic trioxide poisoning. Hum Exp Toxicol 1999; 18(10): 640–641
https://doi.org/10.1191/096032799678839509 pmid: 10557017
7 Zimmerman JL, Shen MC. Rhabdomyolysis. Chest 2013; 144(3): 1058–1065
https://doi.org/10.1378/chest.12-2016 pmid: 24008958
8 Moscetti L, Nelli F, Ruggeri EM. Rhabdomyolysis from erlotinib: a case report. Tumori 2011; 97(3): 415–416
pmid: 21789026
9 Ruggeri EM, Cecere FL, Moscetti L, Doni L, Padalino D, Di Costanzo F. Severe rhabdomyolysis during sunitinib treatment of metastatic renal cell carcinoma: a report of two cases. Ann Oncol 2010; 21(9): 1926–1927 
https://doi.org/DOI: 10.1093/annonc/mdq395 pmid: 20729535 
10 Quezada G, Kopp L, Estey E, Wells RJ. All-trans-retinoic acid and arsenic trioxide as initial therapy for acute promyelocytic leukemia. Pediatr Blood Cancer 2008; 51(1): 133–135
https://doi.org/10.1002/pbc.21529 pmid: 18293388
11 Rogers JE,Yang D. Differentiation syndrome in patients with acute promyelocytic leukemia. J Oncol Pharm Pract 2012; 18(1): 109–114 
https://doi.org/10.1177/1078155211399163 pmid: 21364078
12 Mendila M, Walter GF, Stoll M, Schmidt RE. Rhabdomyolysis in antiretroviral therapy with Lamivudin. Dtsch Med Wochenschr 1997; 122(33): 1003–1006
https://doi.org/10.1055/s-2008-1047721 pmid: 9296927
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed