title: The use of cardiac biopsy to demonstrate reduced cardiotoxicity in AIDS Kaposi's sarcoma patients treated with pegylated liposomal doxorubicin.
abstract: BACKGROUND
  Pegylated liposomal doxorubicin (PL-DOX) has been shown in preclinical models to induce less cardiotoxicity than non-liposomal doxorubicin. Endomyocardial biopsy is a highly sensitive and specific method for detecting anthracycline-induced cardiac damage.
  
  
  METHODS
  Myocardial tissue from ten KS patients who had received cumulative PL-DOX (20 mg/m2/biweekly) of 440-840 mg/m2 was evaluated for evidence of anthracycline-induced cardiac damage. Controls were assembled from patients who had received cumulative doxorubicin doses of 174-671 mg/m2 in two earlier cardiac biopsy protocols. Two control groups were selected on the basis of both cumulative (+/- 10 mg/m2) and peak doxorubicin dose (60 or 20 mg/m2, control group 1), or peak dose alone (20 mg/m2, control group 2).
  
  
  RESULTS
  PL-DOX patients had significantly lower biopsy scores compared with those of doxorubicin controls despite higher cumulative doses of anthracycline. The median biopsy scores for the PL-DOX and doxorubicin groups, respectively, were 0.3 vs. 3.0 (P = 0.002, Cochran-Mantel-Haenszel row mean difference test) for group 1 and 1.25 for group 2 (P < 0.001, Wilcoxon rank-sum test).
  
  
  CONCLUSIONS
  Less severe cardiac changes were seen in patients given PL-DOX relative to historical control patients given comparable cumulative doses of doxorubicin.
authors.affiliation: Department of Surgical Pathology, Stanford University, CA, USA.
authors.forename: G
authors.initials: G
authors.lastname: Berry
authors.forename: M
authors.initials: M
authors.lastname: Billingham
authors.forename: E
authors.initials: E
authors.lastname: Alderman
authors.forename: P
authors.initials: P
authors.lastname: Richardson
authors.forename: F
authors.initials: F
authors.lastname: Torti
authors.forename: B
authors.initials: B
authors.lastname: Lum
authors.forename: A
authors.initials: A
authors.lastname: Patek
authors.forename: F J
authors.initials: FJ
authors.lastname: Martin
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D001706:Biopsy; D004317:Doxorubicin / Q000008:administration & dosage* / Q000009:adverse effects*; D004337:Drug Carriers; D005260:Female; D006321:Heart / Q000187:drug effects*; D006801:Humans; D008081:Liposomes; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D012514:Sarcoma, Kaposi / Q000150:complications / Q000188:drug therapy*; D018709:Statistics, Nonparametric
chemical_list: D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D004337:Drug Carriers; D008081:Liposomes; D004317:Doxorubicin