Subacute cardiotoxicity caused by anthracycline therapy in children: can dexrazoxane prevent this effect?

Abstract

The use of anthracyclines are limited by their cardiotoxic side effects (first of all congestive cardiomyopathy). In this study we analyzed the anthracycline-induced cardiotoxicity and the possible preventive role of dexrazoxane in children. 158 anthracycline-treated long-term survivors could be analyzed. Sixty-one children received dexrazoxane (group D) and 97 patients received anthracyclines only (group C). Cardiac ultrasound examinations (ECHO) and electrocardiograms (ECG) were performed regularly from the beginning of chemotherapy and yearly thereafter. Shortening fraction (FS) was used as indicator of the ventricular function. The incidence of reduced left ventricular function (FS) was 13.4% in C, and 8.2% in D (p=ns). Two years after completion of the chemotherapy FS was reduced in 13.7% in C and 0% in D, respectively (p=0.056), and 5 years after therapy in 11.0% in C and 2.4% in D, respectively (P=0.034). Left chamber wall diameter was abnormal in systole in 6% in C and 2% in D, in diastole in 11% in C and 7% in D (p=ns) after 3 years of follow-up. Anthracycline-induced subacute cardiotoxicity can be significantly diminished by the concomitant use of dexrazoxane. For the final conclusions longer follow-up is necessary.