Outcome of clinical congestive heart failure induced by anthracycline chemotherapy.
BACKGROUND
Anthracycline-induced congestive heart failure (A-CHF) is associated with a high reported incidence of morbidity and mortality. The long-term clinical outcome of patients with clinical A-CHF is less well defined.


METHODS
A retrospective chart review was done of 19 patients with a clinical diagnosis of A-CHF.


RESULTS
In 19 patients, the mean anthracycline dose was 379 +/- 141 mg/m2 (range, 120-570 mg/m2). The median time from the last dose of the drug to the onset of A-CHF was 4 weeks (range, 1-17 weeks). Seven patients (Group I) died of A-CHF within a median of 6 weeks (range, 1-15 weeks) from onset of disease to death. Twelve patients (Group II) had clinical recovery, three with a complete response, eight had partial improvement, and one had stable disease. Most importantly, four patients who had an intercurrent illness (two patients with infections and two with progression of their malignant lesions) had a relapse of clinical congestive heart failure that was fatal.


CONCLUSIONS
Many (63%) patients recover from clinical A-CHF. However, the cardiac reserve of these patients is limited, and they may require careful medical management during other illnesses or surgical procedures.
Moreb
J S
JS
Department of Medicine, College of Medicine, University of Florida, Gainesville 32610-0277.
Oblon
D J
DJ
D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000139:chemically induced* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
D000903:Antibiotics, Antineoplastic; D003520:Cyclophosphamide