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Long-term serial echocardiographic examination of late anthracycline cardiotoxicity and its prevention by dexrazoxane in paediatric patients
L Elbl, H Hrstkova, I Tomaskova, B Blazek, J Michalek
Language English Country Germany
Document type Clinical Trial, Multicenter Study, Research Support, Non-U.S. Gov't
Grant support
NR8006
MZ0
CEP Register
Digital library NLK
Full text - Část
Source
NLK
SpringerLink Journals
from 1997-01-01 to 2009-04-30
ProQuest Central
from 1996-01-01 to 1 year ago
Medline Complete (EBSCOhost)
from 1997-01-01 to 1 year ago
Nursing & Allied Health Database (ProQuest)
from 1996-01-01 to 1 year ago
Health & Medicine (ProQuest)
from 1996-01-01 to 1 year ago
Family Health Database (ProQuest)
from 1996-01-01 to 1 year ago
Public Health Database (ProQuest)
from 1996-01-01 to 1 year ago
- MeSH
- Anthracyclines * adverse effects therapeutic use MeSH
- Time Factors MeSH
- Daunorubicin adverse effects therapeutic use MeSH
- Child MeSH
- Doxorubicin adverse effects therapeutic use MeSH
- Body Mass Index MeSH
- Cardiovascular Agents administration & dosage therapeutic use MeSH
- Infant MeSH
- Blood Pressure drug effects MeSH
- Humans MeSH
- Adolescent MeSH
- Neoplasms * drug therapy physiopathology MeSH
- Follow-Up Studies MeSH
- Child, Preschool MeSH
- Prospective Studies MeSH
- Antineoplastic Agents administration & dosage therapeutic use MeSH
- Razoxane administration & dosage therapeutic use MeSH
- Heart * physiopathology drug effects MeSH
- Heart Rate drug effects MeSH
- Treatment Outcome MeSH
- Dose-Response Relationship, Drug MeSH
- Echocardiography, Stress MeSH
- Check Tag
- Child MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Clinical Trial MeSH
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic MeSH
The authors conducted an 8-year prospective non-randomised 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/m(2) versus 203+/-86 mg/m(2), median 210 mg/m(2), P <0.04) and a significantly higher percentage of patients received cumulative doses >240 mg/m(2) 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 in both sub-groups.
Department of Cardiology University Hospital Brno Jihlavska 20 62500 Brno Czech Republic
Department of Paediatrics Faculty Hospital Ostrava Ostrava Czech Republic
Department of Paediatrics University Hospital Brno Brno Czech Republic
References provided by Crossref.org
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- $a The authors conducted an 8-year prospective non-randomised 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/m(2) versus 203+/-86 mg/m(2), median 210 mg/m(2), P <0.04) and a significantly higher percentage of patients received cumulative doses >240 mg/m(2) 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 in both sub-groups.
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