[Anthracycline-induced cardiotoxicity: report of fatal cases].
BACKGROUND
Anthracyclines are effective drugs in pediatrics cancer treatment. However, anthracycline-induced cardiotoxicity (AIC) is a serious adverse drug reaction that affects the survival in patients treated for childhood cancer.


METHODS
Case 1: Nine-year-old girl with stage IV Hodgkin lymphoma with 12 epirubicin doses and a cumulative dose of 576 mg/m2. After last chemotherapy dose, the patient was admitted with systemic inflammatory response, asthenia and adinamia. Echocardiography: LVEF of 22%, SF 11% and moderate mitral regurgitation. Patient died 2 days after diagnosed with dilated cardiomyopathy secondary to anthracyclines. Case 2: Fifteen-year-old girl with stage IV Burkitt lymphoma with two epirubicin doses and a cumulative dose of 90 mg/m2. After the last cycle, the patient developed several infectious foci. Echocardiography: LVEF of 49%, SF 20% and dilated left ventricle with septal flattening. Patient died 13 days after diagnosis of dilated cardiomyopathy by anthracyclines.


CONCLUSIONS
AIC is a problem in pediatric patients receiving anthracyclines, monitoring is essential to detect the onset of cardiac damage to provide an intervention to prevent heart failure progress.
Departamento de Farmacología, Centro de Investigación y de Estudios Avanzados, Instituto Politécnico Nacional, Ciudad de México, México. castelan@unam.mx.
Jessica Liliana
JL
Vargas-Neri
Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México.
Osvaldo Daniel
OD
Castelán-Martínez
Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social.
María
M
de Jesús Estrada-Loza
Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social.
Yadira
Y
Betanzos-Cabrera
Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social; Centro de Adiestramiento en Investigación Clínica (CAIC), División de Investigación en Salud, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social/ Facultad de Medicina, Universidad Nacional Autónoma de México.
Rodolfo
R
Rivas-Ruiz
D000293:Adolescent; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D002311:Cardiomyopathy, Dilated / Q000139:chemically induced* / Q000175:diagnosis; D066126:Cardiotoxicity; D002648:Child; D015251:Epirubicin / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006801:Humans
D000903:Antibiotics, Antineoplastic; D015251:Epirubicin
Anthracycline; Cardiotoxicity; Chemotherapy; Heart failure