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Bone Marrow Transplantation (2005) 35, 211212
& 2005 Nature Publishing Group All rights reserved 0268-3369/05 $30.00www.nature.com/bmtCorrespondenceSerum levels of cyclosporine (ng/dL) Heart rate (/min)IsoproterenolCyclosporineSinus bradycardia associated with cyclosporine
following allogeneic hematopoietic stem cell
transplantationBone Marrow Transplantation (2005) 35, 211212.
doi:10.1038/sj.bmt.1704747Published online 8 November 2004Arrhythmia following allogeneic hematopoietic stem-cell
transplantation (allo-HSCT) can be seen in association
with uid overload, dimethyl sulfoxide (DMSO), and
cyclophosphamide. Its cause remains unclear in most cases.A43-year-old man with myelodysplastic syndrome
underwent allo-HSCT from a matched unrelated donor
after conditioning with cyclophosphamide 60 mg/kg for 2
days and busulfan 4 mg/kg for 4 days. Graft-versus-host
disease (GVHD) prophylaxis was a continuous infusion
of cyclosporine 3 mg/kg and short-course methotrexate.
Serum concentration of cyclosporine was maintained
between 250 and 400 ng/dl. On day 19, he developed
acute GVHD, which was successfully treated with
methylprednisolone. On day 23, serum cyclosporine level
was elevated to 450 ng/dl. His heart rate was 3040/min.
Electrocardiogram revealed sinus bradycardia. Echocardiography showed no abnormalities. He had presyncope
with severe diaphoresis on day 24, which responded to
isoproterenol. All medications other than...