Cardiac toxicity following high-dose cyclophosphamide, cisplatin, and BCNU (STAMP-I) for breast cancer.
We retrospectively evaluated 443 breast cancer patients treated with high-dose cyclophosphamide, cisplatin, and BCNU (STAMP-I) with autologous stem cell support to characterize the cardiac toxicity of this regimen. Patients had stage II-III (n = 243) or stage IV (n = 200) breast cancer. We observed an overall 5.1% incidence of cardiac complications, both clinical and subclinical, in the whole group: 4.9% in stage II-III and 5.5% in stage IV patients. Clinical cardiomyopathy (CMP) was observed in 1.6% of stage II-III patients (1 case of fatal grade 5 toxicity and 3 cases of grade 3 CMP) and in 3.5% of patients with stage IV disease (1 case of grade 4 and 6 cases of grade 3). The incidence of cardiac toxicity did not differ significantly between the groups. Prior radiation therapy to the mediastinum or left chest wall (P = .001) and advanced age (P = .01) were independent predictors of an increased risk of the appearance of this complication. No pharmacodynamic correlation was observed between any of the 3 drugs and cardiac toxicity.
Nieto
Y
Y
University of Colorado Bone Marrow Transplant Program, Denver 80262, USA. yago.nieto@uchsc.edu
Cagnoni
P J
PJ
Bearman
S I
SI
Shpall
E J
EJ
Matthes
S
S
Jones
R B
RB
D000328:Adult; D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use* / Q000633:toxicity*; D019540:Area Under Curve; D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000209:etiology; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy*; D009202:Cardiomyopathies / Q000139:chemically induced / Q000209:etiology*; D002330:Carmustine / Q000008:administration & dosage / Q000633:toxicity; D002945:Cisplatin / Q000008:administration & dosage / Q000633:toxicity; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000633:toxicity; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D014182:Transplantation, Autologous; D014964:X-Ray Therapy / Q000009:adverse effects
D003520:Cyclophosphamide; D002945:Cisplatin; D002330:Carmustine