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Cardiac arrhythmia in a CML patient treated with interferons
We report a case of a 33-year-old woman who developed episodes of palpitation while receiving weekly alternating doses of daily intramuscular recombinant interferon alpha-2a (rIFN alpha-2a) and recombinant interferon gamma (rIFN gamma) for Philadelphia chromosome-positive chronic myelogenous leukemia. The electrocardiogram (ECG) and ambulatory Holter monitoring showed first-degree atrioventricular (A-V) block and episodes of junctional tachycardia. The ECG abnormality and palpitation disappeared after discontinuation of therapy. On rechallenge with recombinant interferon alpha-2b (rIFN alpha-2b) alone, there was recurrent palpitation and first-degree A-V block. Subsequent treatment with various doses of rIFN alpha-2b established a dose-response relationship between rIFN alpha-2b and palpitation in our patient. In view of increasing use of rIFNs in the clinical setting, this potential, albeit uncommon, toxicity requires attention and further investigation.
We report a case of a 33-year-old woman who developed episodes of palpitation while receiving weekly alternating doses of daily intramuscular recombinant interferon alpha-2a (rIFN alpha-2a) and recombinant interferon gamma (rIFN gamma) for Philadelphia chromosome-positive chronic myelogenous leukemia. The electrocardiogram (ECG) and ambulatory Holter monitoring showed first-degree atrioventricular (A-V) block and episodes of junctional tachycardia. The ECG abnormality and palpitation disappeared after discontinuation of therapy. On rechallenge with recombinant interferon alpha-2b (rIFN alpha-2b) alone, there was recurrent palpitation and first-degree A-V block. Subsequent treatment with various doses of rIFN alpha-2b established a dose-response relationship between rIFN alpha-2b and palpitation in our patient. In view of increasing use of rIFNs in the clinical setting, this potential, albeit uncommon, toxicity requires attention and further investigation.