Arsenic trioxide induced rhabdomyolysis, a rare but severe side effect, in an APL patient: a case report

Front Med. 2017 Jun;11(2):284-286. doi: 10.1007/s11684-017-0514-y. Epub 2017 Apr 19.

Abstract

Arsenic trioxide (ATO), a component of the traditional Chinese medicine arsenic sublimate, promotes apoptosis and induces leukemic cell differentiation. Combined with all-trans-retinotic acid (ATRA), ATO has become the first-line induction therapy in treating acute promyelocytic leukemia (APL). The most common side effects of ATO include hepatotoxicity, gastrointestinal symptoms, water-sodium retention, and nervous system damage. In this report, we present a rare side effect, rhabdomyolysis, in a 68-year-old female APL patient who was treated with ATO. After taking 10 mg ATO daily for 6 days, she presented shortness of breath, myodynia, elevated creatine kinase, and acute renal insufficiency. This report describes the first case of ATO-induced rhabdomyolysis.

Keywords: APL; arsenic trioxide; rhabdomyolysis.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / chemically induced
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Arsenic Trioxide
  • Arsenicals / adverse effects*
  • Arsenicals / therapeutic use
  • Creatinine / blood
  • Dyspnea / etiology
  • Female
  • Humans
  • Leukemia, Promyelocytic, Acute / drug therapy*
  • Medicine, Chinese Traditional
  • Oxides / adverse effects*
  • Oxides / therapeutic use
  • Rhabdomyolysis / chemically induced*
  • Rhabdomyolysis / physiopathology

Substances

  • Arsenicals
  • Oxides
  • Creatinine
  • Arsenic Trioxide