The Effect of Dexrazoxane on Myocardial Injury in Doxorubicin-Treated Children with Acute Lymphoblastic Leukemia

Lipshultz, Steven E.; Rifai, Nader; Dalton, Virginia; Levy, Donna E.; Silverman, Lewis B.; Lipsitz, Stuart R.; Colan, Steven D.; Asselin, Barbara L.; Barr, Ronald D.; Clavell, Luis A.; Hurwitz, Craig A.; Moghrabi, Albert; Samson, Yvan; Schorin, Marshall A.; Gelber, Richard D.; Sallan, Stephen E.

doi:10.1056/nejmoa035153

Cited by 553 publications

(384 citation statements)

References 40 publications

Supporting

Mentioning

359

Contrasting

Unclassified

Order By: Relevance

“…Although there was initial concern regarding the reduced anti-cancer effects of AC when used with DEX, this finding has not been reproduced in multiple clinical studies. In contrast, in pediatric population with hematological malignancies, it has been used successfully and has shown protective effect against AC related cardiotoxicity when used concomitantly from the beginning of the AC therapy [6]. The role of DEX in adult non-breast cancer patients with preexisting systolic dysfunction has been evaluated and has shown promising results and its should be studied prospectively in this population [7].…”

Section: Editorialmentioning

confidence: 99%

Cardio-Oncology: A Tale of Two Diseases

Ganatra¹

2017

Cardiovasc Pharm Open Access

View full text Add to dashboard Cite

Section: Editorialmentioning

confidence: 99%

Cardio-Oncology: A Tale of Two Diseases

Ganatra¹

2017

Cardiovasc Pharm Open Access

View full text Add to dashboard Cite

“…47 It is most commonly used to identify early myocardial damage during acute coronary syndrome, and has been used for the detection of acute anthracycline cardiotoxicity in childhood cancer patients. 47,48 While cTNT may be useful for early monitoring of myocardial injury, little is known about its role in screening high risk patients, years following initial exposure to cardiotoxic agents.…”

Section: © F E R R a T A S T O R T I F O U N D A T I O N © F E R R A mentioning

confidence: 99%

Cardiovascular disease after hematopoietic cell transplantation - lessons learned

Armenian¹,

Bhatia²

2008

Haematologica

View full text Add to dashboard Cite

H ematopoietic cell transplantation (HCT) has now become the treatment of choice for a large number of malignant and non-malignant diseases.1 It is quite clear that unless effective targeted therapy becomes available, HCT will continue to be offered as a curative therapeutic modality to patients diagnosed with a variety of malignant and non-malignant disorders. Among those who survive the first 2 years, nearly 80% of allogeneic HCT recipients 2,3 and 70% of autologous HCT recipients 4 are expected to become long-term survivors, with an attendant growth in such survivors. Due to improvements in survival rate, major issues for patients undergoing HCT have expanded to include the care and management of survivors, prevention of adverse outcomes, and maintenance of a good health-related quality of life. Some of the well-described complications in this population include subsequent malignancies, cataracts, pulmonary complications, endocrine dysfunction, osteonecrosis, chronic kidney disease, and impairment in functional status due to persistent, chronic graft-versus-host disease (GVHD).5-7 Details regarding cardiovascular dysfunction after HCT are now emerging. [8][9][10] In this issue of the journal, Tichelli et al. publish the results of their retrospective study designed to describe the magnitude of risk of and associated risk factors for the development of arterial events after allogeneic HCT. 10 The events of interest include coronary artery disease, cerebrovascular disease and peripheral artery disease. They report that the cumulative incidence of arterial events at 15 years is 6%, and identify older age at the time of HCT and presence of pre-established cardiovascular risk factors (diabetes, obesity, dyslipidemia, arterial hypertension) as being associated with an increased risk of these outcomes.In a recent study, we used a nested case-control study design to examine the independent role of pre-HCT exposure to therapeutic agents, transplant-related conditioning and co-morbidities in the development of congestive heart failure (CHF) after HCT. 8,9 We identified pre-HCT exposure to anthracyclines and the presence of post-HCT co-morbidities as being associated with delayed CHF after HCT.The best-described therapy-related late cardiac complications include valvular dysfunction, conduction abnormalities, pericarditis, and cardiomyopathy. [11][12][13] Arterial complications can occur as a result of damage to the entire vascular system and include coronary artery disease, cerebrovascular disease, and peripheral artery disease.14,15 While the latency period for many of these diseases can be short, survivors often do not have clinical evidence of disease until several years following HCT.14-16 As with most other complications observed after HCT, cardiovascular complications following HCT are due, in part, to the treatment prior to, during, and following HCT.Age at therapeutic exposure, gender, and past medical history are important considerations when identifying the potential risk of long-term cardiovascular disease. ...

show abstract

“…Of 994 titles and abstracts, four randomised controlled trials met the inclusion criteria (Steinhertz et al, 1993;Iarussi et al, 1994;Lipshultz et al, 2002Lipshultz et al, , 2004) (see Table 1). Each considered a different cardioprotective intervention; two considered continuous infusion vs rapid (bolus) infusion, one each of doxorubicin (Lipshultz et al, 2002) and daunorubicin (Steinhertz et al, 1993), and two considered cardioprotective agents, one each of coenzyme Q10 (Iarussi et al, 1994) and dexrazoxane (Lipshultz et al, 2004).…”

Section: Quantity and Quality Of Researchmentioning

confidence: 99%

Clinical and cost-effectiveness of cardioprotection against the toxic effects of anthracyclines given to children with cancer: a systematic review

et al. 2007

View full text Add to dashboard Cite

This review systematically assessed the evidence on the clinical and cost-effectiveness of cardioprotection against the toxic effects of anthracyclines given to children with cancer. We searched eight electronic databases, including Medline and the Cochrane Library, from inception to January 2006 for systematic reviews and randomised controlled trials that reported death, heart failure, arrhythmias or measures of cardiac performance associated with cardioprotective technologies compared with standard treatment in children treated for cancer with anthracyclines. Economic evaluations were also sought. Inclusion criteria, data extraction and quality assessment were undertaken by standard methodology. Four randomised controlled trials met the inclusion criteria of the review; each had methodological limitations. No economic evaluations were identified. Studies were combined through narrative synthesis. One trial found that continuous infusion of doxorubicin did not offer any cardioprotection over rapid infusion. One suggested that continuous infusion of daunorubicin provoked less cardiotoxicity than rapid infusion. One concluded that dexrazoxane reduces cardiac injury during doxorubicin therapy and one reported a protective effect of coenzyme Q 10 on cardiac function during anthracycline therapy. The evidence on the effectiveness of cardioprotective technologies in children is limited in quality and quantity thus making conclusions difficult. This is surprising given the importance of anthracycline use in children with cancer. Further long-term research, which includes relevant outcome measures, is needed to determine whether technologies influence the development of cardiac damage without limiting the antitumour efficacy of anthracyclines.

show abstract

The Effect of Dexrazoxane on Myocardial Injury in Doxorubicin-Treated Children with Acute Lymphoblastic Leukemia

Cited by 553 publications

References 40 publications

Cardio-Oncology: A Tale of Two Diseases

Cardio-Oncology: A Tale of Two Diseases

Cardiovascular disease after hematopoietic cell transplantation - lessons learned

Clinical and cost-effectiveness of cardioprotection against the toxic effects of anthracyclines given to children with cancer: a systematic review

Contact Info

Product

Resources

About