Pericarditis induced by high-dose cytosine arabinoside chemotherapy

Abstract

Pericarditis is a rare side effect of chemotherapy. We report here the case of a patient treated with high-dose cytosine arabinoside (HD ara-c) who developed severe pericarditis. Interruption of HD ara-c and initiation of corticosteroid treatment were effective in resolving the pericardial effusion. This case illustrates this rare but potentially life-threatening cardiac complication of HD ara-c therapy as well as the beneficial effect of corticosteroid treatment.

Recurrent Pericarditis after Chemotherapy for Acute Myeloid Leukemia: A Case Report and a Modern Approach to Chemotherapy-Induced Pericarditis

“…The time of onset of pericarditis after cytarabine ranges from the 3rd day to the 29th day after completion of chemotherapy [4,5,6,10,11]. In our case, acute pericarditis developed on the 6th and 2nd days after completion of chemotherapy, a time period that is well within the ranges described in the previous reports.…”

“…The cumulative dose of cytarabine provoking pericarditis was usually greater than 10 g/m 2 (ranging from 10 to 30 g/m 2 ), except for 1 patient who received a cumulative cytarabine dose of 1.4 g/m 2 [4,5,6,10,11]. In our case, the cumulative doses of cytarabine in the first and second episodes were 18 and 9 g/m 2 , respectively.…”

“…During the treatment of AML, acute pericarditis may result from various causes that require different treatment approaches: idiopathic pericarditis, infectious pericarditis including tuberculous pericarditis, bacterial and fungal pericarditis [1,2], pericarditis caused by leukemic infiltration [3], or chemotherapy-induced pericarditis [4,5,6,7]. Because AML patients are immunocompromised, the possibility of infection should be explored first.…”

“…Colchicine improved the duration of symptom persistence and lowered the recurrence rate in recurrent pericarditis (CORE trial) [12], and also decreased the recurrence rate during the first episode of acute pericarditis (COPE trial) [13]. In previous reports addressing chemotherapy-induced pericarditis, some patients were managed with pericardiocentesis without further medical management while other patients improved after the administration of anti-inflammatory drugs such as steroids or non-steroidal anti-inflammatory drugs [4,5,7,11]. All of these cases were reported before the COPE and CORE trials, and considering the positive effects of colchicine shown by recent data, colchicine may be considered useful in the management of cytarabine-induced pericarditis.…”

Electrocardiogram is very useful for predicting acute heart failure following myeloablative chemotherapy with hematopoietic stem cell transplantation rescue

“…[1][2][3][4][5] In addition, some anticancer agents used in conditioning regimens for HSCT are known to be cardiotoxic. [6][7][8][9][10] Other studies additionally have reported that dimethylsulfoxide used to freeze grafts is responsible for cardiac dysfunction.…”