Fludarabine-induced bradycardia in allogeneic hematopoietic stem cell transplantation: A retrospective study

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dc.authoridCelik, Serhat/0000-0002-1052-9800
dc.authoridKeklik, Muzaffer/0000-0002-6426-5249
dc.authoridGuven, Zeynep Tugba/0000-0003-1600-9731
dc.contributor.authorCelik, Serhat
dc.contributor.authorGuven, Zeynep Tugba
dc.contributor.authorAltinsoy, Abdullah
dc.contributor.authorTubay, Saziye Esra
dc.contributor.authorKeklik, Muzaffer
dc.contributor.authorUnal, Ali
dc.date.accessioned2025-01-21T16:41:12Z
dc.date.available2025-01-21T16:41:12Z
dc.date.issued2024
dc.departmentKırıkkale Üniversitesi
dc.description.abstractIntroduction 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). The side effect of 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 the conditioning regimen in allo-HSCT recipients and to increase awareness of this issue. Methods 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. Results Fludarabine administration doses and days were higher in the bradycardia group, but no statistically significant difference was observed. In the multivariate analysis, age was the only independent predictor of fludarabine-induced bradycardia (odds ratio (OR) 0.93, 95% confidence interval (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 Age was the only independent predictor of fludarabine-induced bradycardia; therefore, close heart rate monitoring is recommended during fludarabine administration, especially in younger patients.
dc.identifier.doi10.1177/10781552231189868
dc.identifier.endpage866
dc.identifier.issn1078-1552
dc.identifier.issn1477-092X
dc.identifier.issue5
dc.identifier.pmid37475474
dc.identifier.scopus2-s2.0-85165644484
dc.identifier.scopusqualityQ3
dc.identifier.startpage860
dc.identifier.urihttps://doi.org/10.1177/10781552231189868
dc.identifier.urihttps://hdl.handle.net/20.500.12587/24839
dc.identifier.volume30
dc.identifier.wosWOS:001034252900001
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSage Publications Ltd
dc.relation.ispartofJournal of Oncology Pharmacy Practice
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_20241229
dc.subjectAllogeneic stem cell transplantation; bradycardia; conditioning regimen; fludarabine
dc.titleFludarabine-induced bradycardia in allogeneic hematopoietic stem cell transplantation: A retrospective study
dc.typeArticle

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