Acquired long QT syndrome during conditioning for allogeneic stem cell transplantation—are we aware of this side effect?
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Allogeneic stem cell transplantation (SCT) is an established therapy for a broad spectrum of hematologic diseases. Considering comorbidities is crucial for the choice of appropriate conditioning and for the success of SCT. To predict non-relapse mortality and overall survival in patients undergoing SCT, several models like the hematopoietic cell transplantation-specific comorbidity index (HCT-CI) have been developed . While the arrhythmia section of HCT-CI accounts for supra- and ventricular dysrhythmias, QTc prolongation as a risk factor of ventricular arrhythmias and sudden cardiac death has never been addressed. Here, we report a case of an acquired long QT syndrome (ALQTS) developing during FLAMSA-Bu conditioning (fludarabine, cytosine-arabinoside, amasacrine, busulfan, cyclophosphamide) and resulting in torsades de pointes and intrahospital resuscitation .
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Obtained from the patient included in the study.
Obtained in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.
- 1.Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG, Storer B (2005) Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood 106(8):2912–2919. https://doi.org/10.1182/blood-2005-05-2004 CrossRefPubMedPubMedCentralGoogle Scholar
- 2.Schmid C, Schleuning M, Ledderose G, Tischer J, Kolb HJ (2005) Sequential regimen of chemotherapy, reduced-intensity conditioning for allogeneic stem-cell transplantation, and prophylactic donor lymphocyte transfusion in high-risk acute myeloid leukemia and myelodysplastic syndrome. J Clin Oncol 23(24):5675–5687. https://doi.org/10.1200/JCO.2005.07.061 CrossRefPubMedGoogle Scholar
- 3.Marks R, Potthoff K, Hahn J, Ihorst G, Bertz H, Spyridonidis A, Holler E, Finke JM (2008) Reduced-toxicity conditioning with fludarabine, BCNU, and melphalan in allogeneic hematopoietic cell transplantation: particular activity against advanced hematologic malignancies. Blood 112(2):415–425. https://doi.org/10.1182/blood-2007-08-104745 CrossRefPubMedGoogle Scholar
- 5.Miller WP, Shanley R, Dorostkar P (2015) Cardiac QTc interval characteristics before and after hematopoietic stem cell transplantation: an analysis of 995 consecutive patients at a single center. Bone Marrow Transplant 50(7):954–960. https://doi.org/10.1038/bmt.2015.64 CrossRefPubMedPubMedCentralGoogle Scholar
- 6.Akahori M, Nakamae H, Hino M, Yamane T, Hayashi T, Ohta K, Tatsumi N, Kitagawa S, Tsumura K (2003) Electrocardiogram is very useful for predicting acute heart failure following myeloablative chemotherapy with hematopoietic stem cell transplantation rescue. Bone Marrow Transplant 31(7):585–590. https://doi.org/10.1038/sj.bmt.1703890 CrossRefPubMedGoogle Scholar