Cytarabine (Ara-C) is the key drug of AML therapy. It is used not only in remission induction therapy but in consolidation therapy. Moreover, in CBF leukemia patient, consolidation therapy with high dose Ara-C alone therapy (HD-AC) achieves better prognosis than with conventional standard-dose multiagent chemotherapy. Severe myelo-suppression, infection and keratitis are major adverse events with HD-AC, but cardiac toxicity or dysfunction is reported rare. We experienced 4 cases of reversible cardiac dysfunction induced by HD-AC. Methods: We collected medical information from patients who received HD-AC at our hospital from April 2002 to August 2010. We also compared with patients who received conventional consolidation therapy between July 1998 and July 2011.Results
Their mean age is 45.8 (28–58), 3 of them are female. Three patients are CBF leukemia (two are t(8;21), one is inv.16). All of them achieved complete remission by remission induction therapy. They received HD-AC as consolidation therapy. Mean of ejection fraction was decreased from 67.7 to 47.3%. 3 patients were recovered with in 2 week. Only one patient, it was required for 6 months to recover.Conclusions
In our hospital, 10 patients received HD-AC as first consolidation therapy. In 4 heart failure patients, 3 were suffered from sepsis. On the other hand, 10 patients received conventional consolidation therapy. 3 patients suffered from sepsis (eight events), but there were no findings of heart failure. Therefore, we consider that in the patients received HD-AC therapy, heart failure appears severely initiated by infection. Several pericarditis or arrhythmia caused by HD-AC had already reported, although almost all reports were single case report. In conclusion, our report highlighted a high incidence of heart failure in patients who received HD-AC, and cardiac function should be carefully monitored in such cases.