Protective effects of cardioxane against anthracycline-induced cardiotoxicity in relapsed acute myeloid leukemias.
The clinical use of anthracyclines and related antitumor agents is limited by their cumulative dose-related cardiac toxicity. Cardioxane (ICRF-187) is an agent that has been recommended to block selectively this toxicity which e.g. limits the use of daunorubicin (DNR) in doses higher than 550-700 mg/m2. We decided to use cardioxane in patients with relapsed acute myeloid leukemias (AML) who have previously been treated with DNR doses above 500 mg/m2. Seven patients with relapsed AML received cardioxane 30 min before DNR or mitozantrone (MTZ) in doses 8-13x higher than DNR or 40-60x higher than MTZ. Two patients received anthracyclines cumulative doses corresponding to more than 1300 mg/m2 and 1000 mg/m2 of DNR, respectively, without any signs of cardiac toxicity. The other 5AML patients in relapse received 1-3 chemotherapy cycles with cardioxane. Their total cumulative doses of DNR were 550-750 mg/m2 and their left ventricular ejection fraction remained above 50% as were their pretreatment values. Cardioxane seems to be a useful cardioprotective agent in relapsed AML which enables further treatment with anthracyclines.
Lemez
P
P
Institute of Hematology and Blood Transfusion, Prague, Czech Republic.
Maresová
J
J
D000208:Acute Disease; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects / Q000037:antagonists & inhibitors*; D000970:Antineoplastic Agents / Q000494:pharmacology*; D002317:Cardiovascular Agents / Q000494:pharmacology*; D003561:Cytarabine / Q000627:therapeutic use; D003630:Daunorubicin / Q000009:adverse effects / Q000037:antagonists & inhibitors*; D005260:Female; D006321:Heart / Q000187:drug effects*; D006801:Humans; D007951:Leukemia, Myeloid / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011929:Razoxane / Q000494:pharmacology*; D012008:Recurrence
D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D002317:Cardiovascular Agents; D003561:Cytarabine; D011929:Razoxane; D003630:Daunorubicin