title: Cardiotoxicity following cyclophosphamidetherapy: a case report.
abstract: BACKGROUND
  Cardiac toxicity is one of the life-threatening complications of cancer therapy. Systemic anticancer treatments may exert their own toxic effects or can aggravate adverse effects of other drugs. We report a case of cyclophosphamide-induced cardiotoxicity in a patient with normal cardiac functions before chemotherapy.
  
  
  METHODS
  A 66-year-old Caucasian woman with a mediastinal mass diagnosed with Burkitt lymphoma underwent chemotherapy with rituximab-hyperfractionated-cyclophosphamide-vincristine-doxorubicin-dexamethasone. On the seventh day of chemotherapy, she developed dyspnea. An electrocardiogram demonstrated low voltage in the limb and precordial leads. It also showed diffusely increased myocardial echogenicity, mild pericardial and pleural effusion, generally impaired biventricular systolic functions with a left ventricular ejection fraction of 31%, and right ventricular mid-apical akinesia, even though she had normal biventricular functions before chemotherapy. Cyclophosphamide-induced cardiotoxicity was suspected and she was given treatment for congestive heart failure. Her dyspnea decreased and she was discharged on the tenth day with a left ventricular ejection fraction of 37% and normal right ventricular function. After 1 month, echocardiography showed normal biventricular functions with a left ventricular ejection fraction of 60%.
  
  
  CONCLUSIONS
  Drug-induced cardiotoxicity, therefore, should be taken into consideration when using cyclophosphamide therapy, especially when anthracyclines are co-administered. Close communication between hematologists and cardiologists is required.
authors.affiliation: Department of Hematology, Baskent University Istanbul Medical and Research Center, İstanbul, Turkey. f_noyan@yahoo.com.
authors.forename: Figen
authors.initials: F
authors.lastname: Atalay
authors.forename: Oyku
authors.initials: O
authors.lastname: Gulmez
authors.forename: Aylin
authors.initials: A
authors.lastname: Ozsancak Ugurlu
mesh_terms: D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000633:toxicity*; D002051:Burkitt Lymphoma / Q000188:drug therapy; D066126:Cardiotoxicity / Q000175:diagnosis / Q000209:etiology; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use / Q000633:toxicity*; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000139:chemically induced; D006801:Humans; D010490:Pericardial Effusion / Q000139:chemically induced; D010996:Pleural Effusion / Q000139:chemically induced; D013318:Stroke Volume / Q000187:drug effects; D018754:Ventricular Dysfunction / Q000139:chemically induced* / Q000175:diagnosis
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003520:Cyclophosphamide