Long-Term Cardiac Follow-up 4–13 Years after Anthracycline Therapy
Myocardial damage is the major limiting toxicity of anthracycline chemotherapy. Cardiac decompensation can occur during therapy or months after the last dose, and it entails a high morbidity [1–3]. The immediate clinical course and short-term prognosis has been well documented, and the incidence has been definitely correlated with the cumulative dose of anthracycline received [1–3]. Although dose limitation, noninvasive monitoring, and cardiac biopsy have reduced the incidence of cardiac failure , clinical toxicity still occurs . Moreover, it is clear that even at low doses, subclinical myocardial damage is seen pathologically on biopsy specimens [3, 5]. Improvement of myocardial function has been reported in surviving patients during the first 4 years after treatment [4, 5]. However, there have been no greater range studies of either the outcome of patients with clinical anthracycline cardiomyopathy or the cardiac status of asymptomatic patients who received anthracyclines in the range reported to be associated with pathologic changes. The long-term cardiac status is particularly important in children who look forward to decades of active life once their cancer is eradicated. We reviewed the history and echocardiograms of 100 patients who both received daunorubicin and/or doxorubicin in multiagent chemotherapy and survived from 4–13 years after this therapy was discontinued.
KeywordsToxicity Lymphoma Leukemia Sarcoma Doxorubicin
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