Review
Early anthracycline cardiotoxicity☆

https://doi.org/10.1016/0002-9343(78)90802-1Get rights and content

Abstract

Eight patients in whom cardiac dysfunction developed within four weeks of receiving their first or second course of daunorubicin or doxorubicin are described. Four patients presented with pericarditis; three of these four had evidence of myocardial dysfunction. Histopathologic analysis of these patients was consistent with an acute myocyte damage and secondary inflammatory process. An additional group of four patients presented with symptoms and signs of heart failure. These patients were either elderly or had evidence of previous cardiac disease. One of these patients suffered a myocardial infarction 24 hours after receiving 60 mg/m2 of daunorubicin; earlier doses in the same course had been associated with evidence of myocardial ischemia. We conclude that anthracycline antibiotics may manifest clinically significant cardiotoxicity at total cumulative doses much less than have been associated with chronic cardiomyopathy.

References (27)

  • EA Lefrak et al.

    A clinicopathologic analysis of adriamycin cardiotoxicity

    Cancer

    (1973)
  • LM Buja et al.

    Cardiac ultrastructural changes induced by daunorubicin therapy

    Cancer

    (1973)
  • RH Blum et al.

    Adriamycin. A new anticancer drug with significant clinical activity

    Ann Intern Med

    (1974)
  • EP Cortes et al.

    Adriamycin (NSC-123127) cardiotoxicity. A clinicopathologic correlation

    Cancer Chemother Rep

    (1975)
  • AC Gilladoga et al.

    Cardiotoxicity of adriamycin (NSC-123127) in children

    Cancer Chemother Rep

    (1975)
  • RM Minow et al.

    Adriamycin cardiomyopathy—risk factors

    Cancer

    (1977)
  • JF Halazun et al.

    Daunorubicin cardiac toxicity in children with acute lymphocytic leukemia

    Cancer

    (1974)
  • AC Gilladoga et al.

    The cardiotoxicity of adriamycin and daunomycin in children

    Cancer

    (1976)
  • DD Von Hoff et al.

    Daunomycininduced cardiotoxicity in children and adults. A review of 110 cases

    Am J Med

    (1977)
  • MR Bristow et al.

    Doxorubicin cardiomyopathy. Evaluation by phonocardiography, endomyocardial biopsy, and cardiac catheterization

    Ann Intern Med

    (1978)
  • L Lenaz et al.

    Cardiotoxicity of adriamycin and related anthracyclines

    Cancer Treat Rev

    (1976)
  • GA Starkebaum et al.

    Early onset of daunorubicin (daunomycin) and cardiotoxicity (letter)

    Lancet

    (1975)
  • DT Harrison et al.

    Pericarditis in a case of early daunorubicin cardiomyopathy

    Ann Intern Med

    (1976)

    • Cited by (0)

    ☆

    This work was supported in part by NIH Grant No. HL-5866.

    1

    From the Division of Cardiology and the Department of Pathology, Stanford University School of Medicine, Stanford, California.

    View full text
    Copyright © 1978 Published by Excerpta Medica Inc.