Mitoxantrone-induced cardiotoxicity

Abstract

Anthracycline-induced cardiotoxicity has been well documented in the literature. Doxorubicin has been most commonly implicated; however, electrocardiogram changes have also been reported with the use of mitoxantrone. We report a case of a 55-year-old female with recurrent acute myelogenous leukemia who underwent reinduction therapy with mitoxantrone and etoposide daily for five doses. Nearing completion of her fifth mitoxantrone dose, she complained of chest tightness and developed bradycardia. Her symptoms resolved with discontinuation of the agent; however, upon rechallenge, she again developed sinus bradycardia with premature ventricular contractions and a corrected QT interval of 0.499 seconds. Clinicians should be aware of the risk factors for mitoxantrone-induced cardiotoxicity and monitor their patients appropriately while on therapy.

Understanding cancer and the anticancer activities of naphthoquinones – a review

“…117- 119 The survival rate of children suffering from first relapse of acute lymphoblastic leukaemia was also improved by Mitoxantrone treatment. 121 It has a similar activity to that of doxorubicin but produces significantly less cardiac toxicity in patients with previously treated breast cancer. It is also has less cardiac toxicity as a result of a decreased ability to participate in ROS generation.…”

“…The main disadvantage of mitoxantrone is its cardiac toxicity. 121 It has a similar activity to that of doxorubicin but produces signicantly less cardiac toxicity in patients with previously treated breast cancer. 122 Mitoxantrone has also been used clinically to treat solid tumours.…”