title: Cyclophosphamide-induced cardiotoxicity with a prolonged clinical course diagnosed on an endomyocardial biopsy.
abstract: A 31-year-old woman with primary mediastinal large B-cell lymphoma refractory to conventional chemotherapy was treated with high-dose chemotherapy containing cyclophosphamide (CY). Subsequently, she was treated with auto peripheral blood stem cell transplantation. Although a complete remission was obtained, heart failure developed two months later. Echocardiography showed an impaired systolic function with pericardial effusion. A biopsy of the endomyocardial region from the left ventricle demonstrated spotty myocardial hemorrhage and myocardial fibrosis with disruption and aggregation of mitochondrial cristae. Based on these findings, CY-induced cardiotoxicity was diagnosed. The patient was treated with conventional therapy for heart failure, which required approximately one year to improve her condition.
authors.affiliation: Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan.
authors.forename: Saburo
authors.initials: S
authors.lastname: Kusumoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kawano
authors.forename: Tomayoshi
authors.initials: T
authors.lastname: Hayashi
authors.forename: Osami
authors.initials: O
authors.lastname: Satoh
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Yonekura
authors.forename: Masamichi
authors.initials: M
authors.lastname: Eguchi
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Takeno
authors.forename: Akira
authors.initials: A
authors.lastname: Tsuneto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Koide
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Jo
authors.forename: Koji
authors.initials: K
authors.lastname: Maemura
mesh_terms: D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects*; D001706:Biopsy; D054715:Cardiotoxins / Q000009:adverse effects*; D003520:Cyclophosphamide / Q000009:adverse effects*; D005260:Female; D006333:Heart Failure / Q000139:chemically induced* / Q000175:diagnosis*; D006801:Humans; D009206:Myocardium / Q000473:pathology*; D013997:Time Factors
chemical_list: D018906:Antineoplastic Agents, Alkylating; D054715:Cardiotoxins; D003520:Cyclophosphamide