Nachtigal Emily A, Doan Thanh Nga
Hematology and Oncology, Olive View University of California Los Angeles Medical Center, Los Angeles, USA.
Cureus. 2022 Dec 31;14(12):e33185. doi: 10.7759/cureus.33185. eCollection 2022 Dec.
Acute promyelocytic leukemia (APL) is a form of leukemia in which there is an arrest of the maturation of the myeloid lineage at the promyelocyte stage. Although there is high early mortality due to coagulopathy, APL is now a curable disease with the use of arsenic trioxide (ATO) and all-trans-retinoic acid (ATRA). Arsenic is weight-based for the treatment of APL, and many toxicities are dose-dependent, although there are no guidelines regarding dosing adjustments for obese patients. We present a case of a 34-year-old male with obesity and APL who developed arsenic-induced QTc prolongation and symptomatic sinus tachycardia while receiving treatment. Further research is needed to guide appropriate dosing for obese patients to determine if ideal body weight dosing is able to provide similar cure rates with fewer adverse events.
急性早幼粒细胞白血病（APL）是一种白血病，其髓系细胞系在早幼粒细胞阶段成熟受阻。尽管由于凝血病导致早期死亡率很高，但目前使用三氧化二砷（ATO）和全反式维甲酸（ATRA）可治愈APL。砷用于治疗APL时是根据体重给药的，许多毒性反应呈剂量依赖性，尽管目前尚无针对肥胖患者调整剂量的指南。我们报告一例34岁肥胖男性APL患者，在接受治疗时出现砷诱导的QTc延长和症状性窦性心动过速。需要进一步研究以指导肥胖患者的适当给药，以确定理想体重给药是否能够在减少不良事件的情况下提供相似的治愈率。
