Supportive Care in Cancer

, Volume 14, Issue 2, pp 128–136

Late anthracycline cardiotoxicity protection by dexrazoxane (ICRF-187) in pediatric patients: echocardiographic follow-up

  • Lubomir Elbl
  • Hana Hrstkova
  • Iva Tomaskova
  • Jaroslav Michalek
Original Article

DOI: 10.1007/s00520-005-0858-8

Cite this article as:
Elbl, L., Hrstkova, H., Tomaskova, I. et al. Support Care Cancer (2006) 14: 128. doi:10.1007/s00520-005-0858-8

Abstract

Background

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.

Patients and methods

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.

Results

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.

Conclusions

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).

Keywords

Dexrazoxane Anthracycline Cardiotoxicity Children 

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Lubomir Elbl
    • 1
  • Hana Hrstkova
    • 2
  • Iva Tomaskova
    • 1
  • Jaroslav Michalek
    • 2
  1. 1.Department of Cardiopulmonary TestingUniversity Hospital BrnoBrnoCzech Republic
  2. 2.1st Department of PediatricsUniversity Hospital BrnoBrnoCzech Republic

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