Anthracycline cardiomyopathy in children: report of two cases.
Two children with leukemia are presented, each demonstrating an unusual aspect of anthracycline-induced cardiomyopathy. In the first patient (a 7-month-old female with acute monocytic leukemia) extremely young age and previous chemotherapy with a podophyllotoxin derivative, VP-16, may have prediposed the patient to fatal congestive heart failure at a total Daunorubicin dose of only 225 mg/m2. In the second patient, a delay of 4 1/2 years was not sufficient in preventing congestive heart failure resulting from the administration of additional anthracycline chemotherapy. We conclude that extremely young age and, possibly, prior therapy with VP-16 may be addition risk factors in the development of anthracycline cardiomyopathy. Also, we suggest that once an anthracycline agent has reached a toxic threshold for the myocardium, the heart may always be at risk to injury from additional Adriamycin or Daunorubicin therapy.
D002648:Child; D003630:Daunorubicin / Q000009:adverse effects*; D004317:Doxorubicin / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005047:Etoposide / Q000009:adverse effects; D005260:Female; D006333:Heart Failure / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D007223:Infant; D007945:Leukemia, Lymphoid / Q000188:drug therapy; D007948:Leukemia, Monocytic, Acute / Q000188:drug therapy; D008854:Microscopy, Electron; D009210:Myofibrils / Q000648:ultrastructure
D005047:Etoposide; D004317:Doxorubicin; D003630:Daunorubicin