Side Effects > Cardiac (Heart)

Last update: 03/15/2010

TOPIC SEARCH: PubMed - anthracyclines | 
PubMed - general | Medscape

Anthracyclines (such as doxorubicin) are an important component for the treatment of various lymphomas, known to have a spectrum of toxicity, particularly cardiac toxicity. Cardio toxicity is increased in the elderly and pediatric patients

 “The incidence of congestive heart failure secondary to doxorubicin-induced cardiomyopathy depends on the cumulative dose of the drug.

At total doses of less than 400 mg/m2 body surface area, the incidence of congestive heart failure is 0.14%;  … this incidence increases to 7% at a dose of 550 mg/m2 body surface area and to 18% at a dose of 700 mg/m2 body surface area [6] (Figure 1).

The rapid increase in clinical toxicity at doses greater than 550 mg/m2 body surface area has made the 550-mg dose the popular empiric limiting dose for doxorubicin-induced cardiotoxicity. “ ¹¹

Resources

• Liposomal doxorubicin (Doxil™)  PAL

References and Research News

1. Valsartan May Prevent CHOP-Induced Cardiotoxicity  Medscape (free login req.)

2. Nad(p)h oxidase and MRP genetic polymorphisms associate with doxorubicin-induced cardiotoxicity.  ASCO 2004  Abstract No: 3021 

3. Early cardiotoxicity of the CHOP regimen in aggressive non-Hodgkin's lymphoma. 
   Ann Oncol. 2003 Feb;14(2):277-81. PMID: 12562656 

4. Safety and efficacy of pegylated liposomal doxorubicin (Doxil) in relapsed epithelial ovarian cancer patients: Effect of age and previous treatment. ASCO 2003 (3186)

5. Late cardiac effects of doxorubicin therapy for acute lymphoblastic leukemia in childhood.
   N Engl J Med. 1991 Mar 21;324(12):808-15. PMID: 1997853 | Related articles

6. Cardiac toxicity of alemtuzumab in patients with mycosis fungoides/Sezary syndrome.
   Blood. 2004 Aug 1;104(3):655-8. Epub 2004 Apr 08. Review. PMID: 15073032 | Related articles

7. Pixantrone, A New Anthracycline with Possibly Less Cardiotoxicity  cancerconsultants.com  Jan 2005

8. Early cardiotoxicity of the CHOP regimen in aggressive non-Hodgkin's lymphoma.
   Ann Oncol. 2003 Feb;14(2):277-81. PMID: 12562656

9. B-type natriuretic peptide (BNP) levels in patients receiving high-dose chemotherapy can detect those at risk of late cardio toxicity  medscape.com (free login req.)

10. Patients with NHL Treated with Anthracyclines at Long-Term Risk for Chronic Heart Failure (2006)
     
    According to an article recently published in the journal Blood, patients with aggressive non-Hodgkin’s lymphoma who receive six cycles of Adriamycin® (doxorubicin) have an increased risk of cardiovascular disease. These patients should undergo long-term monitoring for cardiac conditions.  cancerconsultants.com

11. NEW Anthracycline-Induced Cardiotoxicity  http://bit.ly/aZOuVR