Adriamycin cardiotoxicity: endomyocardial biopsy evidence of enhancement by irradiation.
Endomyocardial biopsies were examined in 12 patients receiving total doses of Adriamycin from 90 to 445 mg/M2. These patients had also received previous mediastinal irradiation (from less than 600 to 5700 rad) over periods varying from 6 months to 14 years prior to the endomyocardial biopsy. Severity of pathological change in these 12 patients was compared with that of dose-matched control patients who had not received mediastinal radiation. The severity of the histopathologic changes was scored on a scale from 0 (normal) to 3 (marked abnormality). The mean score of the group receiving irradiation (2.0 +/- 0.89) was significantly higher than the score in those not irradiated (1.18 +/- 0.23) (p less than 0.001). Morphological demonstration of a "recall phenomenon" of latent radiation changes by Adriamycin was demonstrated in small intramyocardial vessels. This study indicates that radiation, even if remote, enhances Adriamycin-induced cardiomyopathy. Therefore, Adriamycin must be given cautiously in patients who have received previous mediastinal radiotherapy.
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006321:Heart / Q000187:drug effects / Q000528:radiation effects*; D006689:Hodgkin Disease / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*
D004317:Doxorubicin