Exacerbation of anthracycline-induced early chronic cardiomyopathy with ATRA: role of B-type natriuretic peptide as an indicator of cardiac dysfunction.
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.
Mahadeo
Kris Michael
KM
Division of Pediatric Hematology-Oncology, Children's Hospital at Montefiore, Bronx, NY, USA. KRISMD03@hotmail.com
Dhall
Girish
G
Ettinger
Lawrence J
LJ
Kurer
Cheryl C
CC
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*
D000903:Antibiotics, Antineoplastic; D020097:Natriuretic Peptide, Brain; D014212:Tretinoin; D003630:Daunorubicin