title: Exacerbation of anthracycline-induced early chronic cardiomyopathy with ATRA: role of B-type natriuretic peptide as an indicator of cardiac dysfunction.
abstract: Cardiac disease is a significant complication of childhood oncologic therapy. We report the case of a 14-year-old female with acute promyelocytic leukemia who developed symptomatic cardiomyopathy only 4 months into treatment with a combination of daunomycin and all-trans retinoic acid (ATRA). Despite cessation of daunomycin, she demonstrated fluctuating systolic function in relation to ATRA administration. Improvement and deterioration in systolic function on echocardiogram and serum B-natriuretic peptide levels were seen while receiving ATRA 1 week on and 1 week off, respectively, during the maintenance phase of therapy.
authors.affiliation: Division of Pediatric Hematology-Oncology, Children's Hospital at Montefiore, Bronx, NY, USA. KRISMD03@hotmail.com
authors.forename: Kris Michael
authors.initials: KM
authors.lastname: Mahadeo
authors.forename: Girish
authors.initials: G
authors.lastname: Dhall
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Ettinger
authors.forename: Cheryl C
authors.initials: CC
authors.lastname: Kurer
mesh_terms: D000293:Adolescent; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D009202:Cardiomyopathies / Q000139:chemically induced*; D002908:Chronic Disease; D003630:Daunorubicin / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications / Q000188:drug therapy*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D014212:Tretinoin / Q000009:adverse effects*
chemical_list: D000903:Antibiotics, Antineoplastic; D020097:Natriuretic Peptide, Brain; D014212:Tretinoin; D003630:Daunorubicin