Does the multidrug-resistance modulator cyclosporin A increase the cardiotoxicity of high-dose anthracycline chemotherapy?
Cyclosporin A has heterogeneous effects on anthracycline-related cardiotoxicity and can prevent multidrug-resistance (MDR). The aim of this study was to explore whether the coadministration of cyclosporin A is accompanied by an increase in cardiotoxicity. Forty-three patients (27 male, 16 female, age: 18-67 yrs [mean: 47.5 yrs, SD: 11.6 yrs]) received 177 radionuclide ventriculography examinations (RNV 177 at rest, 133 at stress) before and during chemotherapy with either doxorubicin (n = 23) or epirubicin (n = 20). RNV studies were applied up to 11 times in the follow-up of the patients. A maximum of 10 courses of chemotherapy was performed. In the doxorubicin group only, the age of the patients and the cumulative dose of the chemotherapeutic agent had a significant negative impact on left ventricular ejection fractions, whereas cyclosporin A had a significant positive influence (multiple analysis of regression, p < 0.05). Cyclosporin A did not cause any significant increase in cardiotoxicity in our patients.
Eising
E G
EG
Clinic and Policlinic for Nuclear Medicine, University of Essen, Germany.
Gries
P
P
Eggert
J
J
Scheulen
M E
ME
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000818:Animals; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects* / Q000627:therapeutic use; D016572:Cyclosporine / Q000494:pharmacology*; D004317:Doxorubicin / Q000009:adverse effects* / Q000627:therapeutic use; D018432:Drug Resistance, Multiple; D004357:Drug Synergism; D015251:Epirubicin / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006321:Heart / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D016277:Ventricular Function, Left / Q000187:drug effects*
D000903:Antibiotics, Antineoplastic; D007166:Immunosuppressive Agents; D015251:Epirubicin; D004317:Doxorubicin; D016572:Cyclosporine