Journal Information
Vol. 46. Issue S3.
X Eurasian Hematology Oncology Congress
Pages 6 (May 2024)
Vol. 46. Issue S3.
X Eurasian Hematology Oncology Congress
Pages 6 (May 2024)
Adult Hematology Abstract Categories, Stem Cell TransplantOP 08
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FLUDARABINE-INDUCED BRADYCARDIA IN ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION
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Serhat Çelik1, Zeynep Tuğba Güven2, Abdullah Altınsoy3, Şaziye Esra Tubay4, Muzaffer Keklik5, Ali Ünal5
1 Department of Hematology, Yenimahalle Training and Research Hospital, Yıldırım Beyazıt University, Ankara, Türkiye
2 Department of Hematology, Adana City Hospital, Adana, Türkiye
3 Department of Internal Medicine, Faculty of Medicine, Erciyes University, Kayseri, Türkiye
4 Department of Clinical Pharmacy, Faculty of Pharmacy, Erciyes University, Kayseri, Türkiye
5 Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Türkiye
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Vol. 46. Issue S3

X Eurasian Hematology Oncology Congress

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Objective

Fludarabine, a purine analog, is getting more attention with the increasing use of reduced intensive conditioning regimens in allogeneic hematopoietic stem cell transplantation (allo-HSCT). Bradycardia was observed in only a few cases reported in the literature. In clinical practice, bradycardia can be asymptomatic or cause syncope and cardiac arrest. This study aimed to evaluate the bradycardia side effect of fludarabine used in allo-HSCT recipients and to increase awareness of this issue.

Methodology

This retrospective study included 73 patients who received fludarabine in the allo-HSCT conditioning regimen between January 2015 and January 2021. Patients with and without bradycardia were compared regarding demographic data, allo-HSCT characteristics, electrolyte values, fludarabine administration dose and duration, and survival. Univariate and multivariate analyzes were performed to evaluate independent predictors for fludarabine-induced bradycardia (FİB).

Results

Fludarabine doses were higher in the bradycardia group, but not statistically significant. Age was the only independent predictor of FİB (OR 0.93, 95% CI: 0.89-0.98, p =0.007). The median age in the group with bradycardia was 19 years younger than those without bradycardia (34 (19-49) vs 53 (19-69), p=0.005). In 11 (84.6%) of the patients who had bradycardia, bradycardia improved with the discontinuation of fludarabine alone, but atropine was administered in 2 (15.4%) patients.

Conclusion

Bradycardia was observed in 17.8% of our patients who used fludarabine in the conditioning regimen. Age was the only independent predictor of fludarabine-induced bradycardia; therefore, close heart rate monitoring is recommended during fludarabine administration, especially in younger patients. Although our results are promising, further studies evaluating the fludarabine intermediate fluoroadenosine are needed to support our results.

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Hematology, Transfusion and Cell Therapy
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