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Mitoxantrone-induced cardiotoxicity

Departments of Pharmacy, Medicine and Nursing, State University of New York, Upstate Medical University, University Hospital, 750 East Adams Street, Syracuse, New York 13210.

Adrienne L Smith, PharmD

Departments of Pharmacy, Medicine and Nursing, State University of New York, Upstate Medical University, University Hospital, 750 East Adams Street, Syracuse, New York 13210

Evelyn L King, RN

Departments of Pharmacy, Medicine and Nursing, State University of New York, Upstate Medical University, University Hospital, 750 East Adams Street, Syracuse, New York 13210

Sara J Grethlein, MD

Departments of Pharmacy, Medicine and Nursing, State University of New York, Upstate Medical University, University Hospital, 750 East Adams Street, Syracuse, New York 13210

Anthracycline-induced cardiotoxicity has been well documented in the literature. Doxorubicin has been most commonly implicated; however, electrocardiogram changes have also been reported with the use of mitoxantrone. We report a case of a 55-year-old female with recurrent acute myelogenous leukemia who underwent reinduction therapy with mitoxantrone and etoposide daily for five doses. Nearing completion of her fifth mitoxantrone dose, she complained of chest tightness and developed bradycardia. Her symptoms resolved with discontinuation of the agent; however, upon rechallenge, she again developed sinus bradycardia with premature ventricular contractions and a corrected QT interval of 0.499 seconds. Clinicians should be aware of the risk factors for mitoxantrone-induced cardiotoxicity and monitor their patients appropriately while on therapy.

Key Words: Mitoxantrone • cardiotoxicity

Journal of Oncology Pharmacy Practice, Vol. 7, No. 1, 47-48 (2001)
DOI: 10.1191/1078155201jp079cr


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