The authors conducted an 8-year prospective non-random-ised study to determine whether dexrazoxane (ICRF-187) would reduce late anthracycline-induced cardiotoxicity in patients treated in childhood for haematological ...The authors conducted an 8-year prospective non-random-ised study to determine whether dexrazoxane (ICRF-187) would reduce late anthracycline-induced cardiotoxicity in patients treated in childhood for haematological malignancy. The authors examined prospectively 75 patients (40 male/35 female) aged 2-17 years (median 6.5 years) at the time of diagnosis. The cardioprotection was given to 53 patients (26 male/17 female) and the standard protocol was used in 22 patients (14 male/8 female). The prospective echocardiographic evaluation was done before and after the chemotherapy and every year during the follow-up period. Dynamic stress echocardiography (DSE) was assessed in the final year. The clinical cardiotoxicity was not diagnosed. Higher cumulative doses of anthracycline were given in the dexrazoxane group (234± 58 mg/m 2, median 240 mg/m2 versus 203± 86 mg/m2, median 210 mg/m2, P < 0.04) and a significantly higher percentage of patients received cumulative doses >240 mg/m2 of anthracycline ( P < 0.05). During the follow-up period, the fractional shortening (FS) declined in the no-dexrazoxane group only in the 8th year and was significantly lower compared to the dexrazoxane group ( P < 0.05). The pathological decrease in FS was present in 24% of patients; 41% in the no-dexrazoxane and 17% in the dexrazoxane groups, respectively ( P < 0.05). DSE demonstrated lower rest EF and cardiac index (CI) in the no-dexrazoxane group ( P < 0.05); however, neither the response of EF and CI to the stress echocardiography nor the exercise tolerance significantly differed between sub-groups. A higher number of patients in the dexrazoxane group had very good exercise tolerance (ET) > 3 Watts/kg ( P < 0.05) and a lower number responded with a decreased ET < 2 Watts/kg ( P < 0.05) compared to the no-dexrazoxane group. Conclusion: 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 展开更多
文摘The authors conducted an 8-year prospective non-random-ised study to determine whether dexrazoxane (ICRF-187) would reduce late anthracycline-induced cardiotoxicity in patients treated in childhood for haematological malignancy. The authors examined prospectively 75 patients (40 male/35 female) aged 2-17 years (median 6.5 years) at the time of diagnosis. The cardioprotection was given to 53 patients (26 male/17 female) and the standard protocol was used in 22 patients (14 male/8 female). The prospective echocardiographic evaluation was done before and after the chemotherapy and every year during the follow-up period. Dynamic stress echocardiography (DSE) was assessed in the final year. The clinical cardiotoxicity was not diagnosed. Higher cumulative doses of anthracycline were given in the dexrazoxane group (234± 58 mg/m 2, median 240 mg/m2 versus 203± 86 mg/m2, median 210 mg/m2, P < 0.04) and a significantly higher percentage of patients received cumulative doses >240 mg/m2 of anthracycline ( P < 0.05). During the follow-up period, the fractional shortening (FS) declined in the no-dexrazoxane group only in the 8th year and was significantly lower compared to the dexrazoxane group ( P < 0.05). The pathological decrease in FS was present in 24% of patients; 41% in the no-dexrazoxane and 17% in the dexrazoxane groups, respectively ( P < 0.05). DSE demonstrated lower rest EF and cardiac index (CI) in the no-dexrazoxane group ( P < 0.05); however, neither the response of EF and CI to the stress echocardiography nor the exercise tolerance significantly differed between sub-groups. A higher number of patients in the dexrazoxane group had very good exercise tolerance (ET) > 3 Watts/kg ( P < 0.05) and a lower number responded with a decreased ET < 2 Watts/kg ( P < 0.05) compared to the no-dexrazoxane group. Conclusion: 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
