Sudden death in leukemic patients treated with doxorubicin.

Cardiotoxicity of the anthracycline antineoplastic drugs is well known, especially the chronic effects, manifested mainly as congestive heart failure. Fewer reports have been published about the acute cardiotoxicity of these medications, and risk factors associated with their use. Two cases of malignant arrhythmias leading to sudden death associated with severe hypokalemia are reported. These cases suggest a synergistic effect between anthracyclines and electrolyte disorders resulting in the acute cardiotoxicity of these drugs. The administration of these antineoplastic drugs should include regular and systematic control of serum electrolytes and correction of hypokalemia during treatment.