Late anthracycline cardiotoxicity protection by dexrazoxane (ICRF-187) in pediatric patients: echocardiographic follow-up
| Autor: | Iva Tomášková, Hana Hrstková, Lubomír Elbl, Jaroslav Michálek |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Anthracycline Adolescent Cardiomyopathy Internal medicine medicine Humans Anthracyclines Child Retrospective Studies Heart Failure Cardiotoxicity Ejection fraction Antibiotics Antineoplastic business.industry Standard treatment Cardiovascular Agents Stroke Volume medicine.disease Survival Analysis Treatment Outcome Oncology Echocardiography Heart failure Child Preschool Hematologic Neoplasms Cardiology Female Dexrazoxane business Isovolumic relaxation time Cardiomyopathies Razoxane medicine.drug Follow-Up Studies |
| Zdroj: | Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 14(2) |
| ISSN: | 0941-4355 |
| Popis: | The authors conducted a retrospective study to determine whether dexrazoxane (ICRF-187) would reduce late anthracycline-induced cardiotoxicity in patients treated in childhood for hematological malignancy. The authors examined 108 patients (63 male, 45 female) 5–29 years old, (median 15 years). All patients were in long-term remission of their malignancy. The cardioprotection was given to 68 patients (39 male, 29 female), and standard treatment was used in 40 patients (24 male, 16 female). Dexrazoxane (cardioxane, Chiron Company, The Netherlands) was given in 20:1 ratio to anthracycline. The follow-up time was 2–20 years (mean 7 years). The control group consisted of 41 volunteers (22 males, 19 females) 4–31 years old (median 18 years). The cardiotoxicity has been defined as the presence of heart failure or the decline of shortening fraction below 30% or ejection fraction (EF) below 55%. The end-systolic wall stress (ESS), myocardial performance index (MPI; Tei index), and parameters of left ventricular diastolic filling were also assessed. The anthracycline cardiomyopathy with the presence of heart failure was diagnosed in only one patient treated with a standard regimen. The pathological decline of fractional shortening was present in three (5%) and six (15%) patients with and without cardioprotection given, respectively. Similarly, none of the patients with cardioprotection revealed a pathological value of EF, while four (10%) patients without cardioprotection showed an EF decrease. Finally, ESS and isovolumic relaxation time were pathologically increased in the group without cardioprotection in comparison to the controls and to the group with cardioprotection. However, the MPI was significantly increased in both groups of patients. Dexrazoxane reduces the risk of late clinical and subclinical cardiotoxicity and does not affect the response rates to chemotherapy and overall survival during the median follow-up period of 7 years (follow-up period 2–20 years). |
| Databáze: | OpenAIRE |
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