Abstract
A 40 year old man was admitted to the hospital due to acute myelogenous leukemia. The hemoglobin was 9.1 gr/dl and white cell count was 11,600/μl with 66% myeloblasts. The platelet count was 8.4×104/μl. Bone marrow examination revealed hypercellular bone marrow with 60% myeloblasts. ECG and chest X-ray were within normal limit. Remission induction therapy was treated with BH-AC. DMP (BH-AC 250 mg, DNR 60 mg, 6MP 70 mg, PSR 40 mg). As complete remission was not obtained by one course of BH-AC. DMP therapy, the second course of the BH-AC. DMP therapy was started. Three minutes after the slow infusion of daunorubicin (60 mg) on the first day of the second course, the patient suddenly lost consciousness and underwent a cardiac arrest. Resuscitation attempts were succesful and unconsciousness was recovered 15 minutes after the shock. Transient I° A-V block was recognized by ECG, but the values of GOT, LDH and CPK were not changed. Cardioechography and Holter ECG after the shock revealed no change. This accident occured by acute cardiac dysfunction due to daunorabicin administration. The importance of careful observation of the patient receiving daunorubicin was stressed, because the acute cardiac dysfunction was possibly to be happened.
