title: Long-term risk of leukaemia or cardiomyopathy after mitoxantrone therapy for multiple sclerosis.
abstract: BACKGROUND
  Mitoxantrone has been extensively used as a disease-modifying therapy for multiple sclerosis. However, estimates of the associated risk of therapy-related acute leukaemia and cardiomyopathy have been derived from short-term studies. This study aimed to ascertain the long-term risk of therapy-related acute leukaemia or cardiomyopathy after mitoxantrone therapy for multiple sclerosis.
  
  
  METHODS
  Between 2002 and 2010, 50 patients were treated with mitoxantrone at a single centre using a standard protocol (12 mg/m(2) body surface area monthly for 6 months as tolerated to a maximum of 72 mg/m(2) body surface area). Follow-up haematologic and echocardiographic data were collected in March 2011.
  
  
  RESULTS
  Fifteen patients (30%) were excluded from analysis either because of lack of follow-up data, death due to non-cardiac and non-haematologic causes, or comorbid cardiovascular disease. The remaining 35 patients (70%) were followed for a median of 75 months (range: 9-103). The median cumulative mitoxantrone dose given was 72 mg/m(2) body surface area (range: 24-123). At the end of follow-up, no patients had developed therapy-related acute leukaemia. One patient suffered an asymptomatic drop in left ventricular ejection fraction from 55 to 47%.
  
  
  CONCLUSIONS
  This series of patients followed for up to 8.5 years suggests that the risk of either therapy-related acute leukaemia or cardiomyopathy after mitoxantrone therapy for multiple sclerosis is low when patients are treated within standard protocol.
authors.affiliation: Dublin Neurological Institute at the Mater Misericordiae University Hospital, Dublin, Ireland.
authors.forename: Eoin
authors.initials: E
authors.lastname: Mulroy
authors.forename: Emer
authors.initials: E
authors.lastname: Joyce
authors.forename: Jaqueline
authors.initials: J
authors.lastname: Scott
authors.forename: Jane
authors.initials: J
authors.lastname: Melling
authors.forename: Carole
authors.initials: C
authors.lastname: Goggin
authors.forename: Niall
authors.initials: N
authors.lastname: Mahon
authors.forename: Killian
authors.initials: K
authors.lastname: O'Rourke
authors.forename: Timothy
authors.initials: T
authors.lastname: Lynch
mesh_terms: D000328:Adult; D000368:Aged; D009202:Cardiomyopathies / Q000139:chemically induced* / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007938:Leukemia / Q000139:chemically induced* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000009:adverse effects* / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000188:drug therapy*; D012306:Risk; D014463:Ultrasonography
chemical_list: D008942:Mitoxantrone