title: The effect of arsenic trioxide on QT interval prolongation during APL therapy.
abstract: OBJECTIVE
  To investigate the cardiac effect of QT interval prolongation in the treatment of acute promyelocytic leukemia (APL) with arsenic trioxide (As(2)O(3)), and the relationship between QT and serum arsenic concentration.
  
  
  METHODS
  Blood serum arsenic concentrations of thirty APL patients were determined at 2 hours, 4 hours, 8 hours, and 24 hours after As(2)O(3) injection using atomic fluorophotometry. Cardiac functions were measured simultaneously using a 12-lead body-surface electrocardiogram (ECG). Q-T intervals were manually measured, and then corrected using Bazett's formula (QTc). QT dispersion (QTd) was also calculated. In order to assess the effects of arsenic on the symptoms of anemia, twenty-four anemia patients were divided into two groups on the basis hemoglobin concentration: Group 1 (Hb > or = 90 g/L), and Group 2 (60 g/L < or = Hb < 90 g/L). QTc and QTd of these patients were also manually measured.
  
  
  RESULTS
  All QT intervals of APL patients treated with As(2)O(3) injection were prolonged [32.2 ms (27, 41 ms); P < 0.05], but the changes of QTd were not prominent [3 ms (-8, 7 ms), P > 0.05]. There was a delay of 2 hours in maximum QTc following peaks in serum arsenic concentration. Changes in QTc and QTd of the two anemic groups were not prominent.
  
  
  CONCLUSIONS
  As(2)O(3) can prolong QTc intervals in APL patients, but the effects are delayed compared to peak serum arsenic concentrations. As(2)O(3) has no prolongation effect on QTd. Mild and moderate anemia do not effect QTc and QTd.
authors.affiliation: Department of Hematology, First Clinical College of Harbin Medical University, Harbin 150001, China. Jinzhou@lycos.com
authors.forename: Jin
authors.initials: J
authors.lastname: Zhou
authors.forename: Ran
authors.initials: R
authors.lastname: Meng
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Li
authors.forename: Chengfang
authors.initials: C
authors.lastname: Lu
authors.forename: Shengjin
authors.initials: S
authors.lastname: Fan
authors.forename: Baofeng
authors.initials: B
authors.lastname: Yang
mesh_terms: D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000494:pharmacology* / Q000627:therapeutic use; D004562:Electrocardiography / Q000187:drug effects*; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy*; D010087:Oxides / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D001152:Arsenicals; D010087:Oxides; D000077237:Arsenic Trioxide