Long-term serial echocardiographic examination of late anthracycline cardiotoxicity and its prevention by dexrazoxane in paediatric patients

Abstract

Dexrazoxane seems to reduce the risk of late subclinical cardiotoxicity. Dexrazoxane-treated patients revealed better exercise tolerance; however the haemodynamic response to the stress was no different in both sub-groups.

Cardiac side-effects of cancer chemotherapy

“…Using serial measurements of troponin I in 101 children given doxorubicin, Lipshultz et al found a lower rate of increased levels (N0.01 ng/ml) when dexrazoxane was associated (21 vs 51% of treated children) (67). Another study in 75 children treated for leukemias or lymphomas showed fewer late (8 years) impairments of LVEF, occurring in 17% of those who received dexrazoxane and 41% in its absence [68].…”

Chemotherapeutikainduzierte Herzinsuffizienz

“…Es ist noch nicht ganz klar, wie der Wirkungsmechanismus ist, jedoch haben mehrere Studien gezeigt, dass Dexrazoxan die Kardiotoxizität von Anthracyclinen um 70-80% verringern kann. Einziges Caveat bleibt die Unsicherheit bezüglich einer eventuellen Reduktion der Antitumoreffizienz der Anthracycline oder eine mögliche Erhöhung der Inzidenz von Sekundär-malignomen [50][51][52][53][54][55][56][57][58][59][60]. Es sind jedoch weitere Studien notwendig, um diese vorläufigen Ergebnisse zu untermauern.…”

Oxidative Stress, Redox Signaling, and Metal Chelation in Anthracycline Cardiotoxicity and Pharmacological Cardioprotection

“…Importantly, the randomized prospective trial by Lipshultz et al has clearly shown that DEX may prevent cardiotoxicity onset in children with &2.5-year follow-up after the chemotherapy (169). A nonrandomized prospective trial by Elbl et al has suggested that DEX affords a long-term cardioprotection from both clinical and subclinical cardiotoxicity in 8-year follow-up after the ANT treatment (57). In addition, a retrospective study in children with a follow-up of 2-20 years (7 years median) suggested a reduction of both clinical and subclinical signs of late-onset cardiotoxicity in children receiving DEX (58).…”