[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. CLINICAL CASES 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. CONCLUSION 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.

[1]  S. Sallan,et al.  Managing Chemotherapy-Related Cardiotoxicity in Survivors of Childhood Cancers , 2014, Pediatric Drugs.

[2]  C. Gale,et al.  Cardiovascular sequelae in long-term survivors of young peoples' cancer: a linked cohort study , 2014, British Journal of Cancer.

[3]  S. Lipshultz,et al.  Treatment-related cardiotoxicity in survivors of childhood cancer , 2013, Nature Reviews Clinical Oncology.

[4]  A. S. Shaikh,et al.  Anthracycline-induced cardiotoxicity: prospective cohort study from Pakistan , 2013, BMJ Open.

[5]  S. Raman,et al.  Occult Cardiotoxicity in Childhood Cancer Survivors Exposed to Anthracycline Therapy , 2013, Circulation. Cardiovascular imaging.

[6]  T. Marwick,et al.  Role of cardioprotective therapy for prevention of cardiotoxicity with chemotherapy: a systematic review and meta-analysis. , 2013, European journal of cancer.

[7]  W. Hundley,et al.  Low to moderate dose anthracycline-based chemotherapy is associated with early noninvasive imaging evidence of subclinical cardiovascular disease. , 2013, JACC. Cardiovascular imaging.

[8]  S. Meikle,et al.  Altered left ventricular longitudinal diastolic function correlates with reduced systolic function immediately after anthracycline chemotherapy. , 2013, European heart journal cardiovascular Imaging.

[9]  S. Lipshultz,et al.  Anthracycline-Associated Cardiotoxicity in Survivors of Childhood Cancer , 2011, Pediatric Cardiology.

[10]  C. Lim,et al.  Mechanisms of anthracycline cardiac injury: can we identify strategies for cardioprotection? , 2010, Progress in cardiovascular diseases.

[11]  J. Bourhis,et al.  Role of cancer treatment in long-term overall and cardiovascular mortality after childhood cancer. , 2010, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[12]  J. Bryant,et al.  Cardioprotection against the toxic effects of anthracyclines given to children with cancer: a systematic review. , 2007, Health technology assessment.

[13]  S. Lipshultz,et al.  Anthracycline-induced cardiotoxicity: course, pathophysiology, prevention and management , 2007, Expert opinion on pharmacotherapy.

[14]  P. Voûte,et al.  Frequency and risk factors of subclinical cardiotoxicity after anthracycline therapy in children: a systematic review. , 2002, Annals of oncology : official journal of the European Society for Medical Oncology.

[15]  D. Keefe,et al.  Anthracycline-induced cardiomyopathy. , 2001, Seminars in oncology.

[16]  M. Green,et al.  New anthracycline antitumor antibiotics. , 1991, Critical reviews in oncology/hematology.

[17]  J. Plana Update : Systemic Diseases and the Cardiovascular System ( IV ) Chemotherapy and the Heart , 2017 .

[18]  G. Roul,et al.  [Anthracycline-induced cardiomyopathy]. , 2009, Presse medicale.

[19]  H. Dickinson,et al.  Cardioprotective interventions for cancer patients receiving anthracyclines. , 2005, The Cochrane database of systematic reviews.

[20]  S. Lipshultz,et al.  Anthracycline-induced cardiotoxicity in children and young adults. , 1998, Critical reviews in oncology/hematology.