Department of Pediatric Hematology-Oncology, Bezmialem University Medical Center, Istanbul, Turkey.
Support Care Cancer. 2012 Oct;20(10):2451-7. doi: 10.1007/s00520-011-1376-5. Epub 2012 Jan 13.
Cardiac side effects of granisetron have been studied mostly in adult patients that are using cardiotoxic chemotherapeutics. There is limited evidence in pediatric age group and no information in pediatric oncology patients with non-cardiotoxic chemotherapeutics.
In this prospective, crossover randomized study, the cardiac side effects of granisetron are compared in pediatric oncology patients who had carboplatin based chemotherapy. They were randomized to receive either 10 or 40 μg kg(-1) dose(-1) of granisetron before each cycle of chemotherapy. We drew blood for creatine phosphokinase (CPK), CPK-muscle band (MB) and Troponin-T before and 24 h after administering granisetron. Electrocardiography (ECG) tracings were taken at 0, 1, 2, 3, 6 and 24 h of granisetron. Twenty-four hours Holter ECG monitorisation was performed after each granisetron infusion.
A total of 16 patients (median 8.7 years of age) were treated with weekly consecutive courses of carboplatin. There was bradycardia (p = 0.000) in patients that had granisetron at 40 μg/kg and PR interval was shortened in patients that had granisetron at 10 μg/kg dose (p = 0.021). At both doses of granisetron, QTc interval and dispersion were found to be similar. CPK, CK-MB and Troponin-T values were found to be normal before and 24 h after granisetron infusion.
As the first study that has studied cardiac side effects of granisetron in patients that are not using cardiotoxic chemotherapeutics, we conclude that granisetron at 40 μg kg(-1) dose(-1) causes bradycardia only. We have also demonstrated that granisetron does not cause any clinically cardiac side effects either at 10 or 40 μg kg(-1) dose(-1). However, our results should be supported by prospective randomized studies with larger samples of patient groups.
格拉司琼的心脏副作用主要在使用心脏毒性化疗药物的成年患者中进行了研究。在儿科年龄组中证据有限，并且在接受非心脏毒性化疗药物的儿科肿瘤患者中没有信息。
在这项前瞻性、交叉随机研究中，比较了接受基于卡铂化疗的儿科肿瘤患者中格拉司琼的心脏副作用。他们被随机分配在每个化疗周期前接受 10 或 40μg/kg 剂量的格拉司琼。我们在给予格拉司琼前后抽取肌酸磷酸激酶（CPK）、CPK-肌带（MB）和肌钙蛋白-T 的血液，并在给予格拉司琼后 24 小时进行。在格拉司琼的 0、1、2、3、6 和 24 小时时记录心电图（ECG）描记图。在每次格拉司琼输注后进行 24 小时动态心电图监测。
共 16 例（中位年龄 8.7 岁）患者接受了每周连续卡铂疗程的治疗。在给予 40μg/kg 格拉司琼的患者中出现心动过缓（p=0.000），而在给予 10μg/kg 剂量的患者中 PR 间期缩短（p=0.021）。在两种剂量的格拉司琼下，QTc 间期和离散度均相似。在给予格拉司琼前后，CPK、CK-MB 和肌钙蛋白-T 值均正常。
作为第一项研究格拉司琼在未使用心脏毒性化疗药物的患者中的心脏副作用的研究，我们的结论是，格拉司琼在 40μg/kg 剂量下仅引起心动过缓。我们还表明，格拉司琼在 10 或 40μg/kg 剂量下均不会引起任何临床心脏副作用。然而，我们的结果应通过具有更大患者群体样本的前瞻性随机研究来支持。
