Aggressive management of doxorubicin-induced cardiomyopathy associated with 'low' doses of doxorubicin.
There is a dose-effect relationship between doxorubicin and the incidence of symptomatic cardiac failure. It is generally thought that doses below 500-550 mg/m2 are safe but, when objective measures of cardiac function are used, it becomes apparent that degrees of cardiac failure occur at doses below this. We present here the case histories of two patients who developed very severe cardiac failure at cumulative doses well below 500 mg/m2 but who survived their initial cardiac illness due to aggressive intervention. In one case, the patient was successfully treated by orthotopic cardiac transplantation.
Department of Medicine, Royal Marsden Hospital, London, UK.
S
S
Sriskandan
M E
ME
O'Brien
I E
IE
Smith
P
P
Collins
M E
ME
Gore
D000293:Adolescent; D002311:Cardiomyopathy, Dilated / Q000139:chemically induced* / Q000628:therapy*; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects*; D004334:Drug Administration Schedule; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D016393:Lymphoma, B-Cell / Q000188:drug therapy; D008875:Middle Aged; D018233:Rhabdomyosarcoma, Embryonal / Q000188:drug therapy
D004317:Doxorubicin