Cardiovascular considerations with anthracycline use in patients with cancer.

M A Nelson, W H Frishman, K Seiter, D Keefe, J Dutcher

Journal: Heart disease (Hagerstown, Md.) 2002;3(3):157-68

PMID: 11975787

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Abstract

Anthracyclines are important chemotherapeutic agents that are used for the treatment of various malignancies in both adults and children, but their usefulness has been limited by cardiotoxicity that is usually dose related. Oxidative injury appears to be the cause of myocardial dysfunction when using these drugs. Screening for early myocardial injury with troponin testing, echocardiography, and radionuclide examinations has reduced the incidence of chronic cardiac dysfunction. Various anthracycline analogues have been developed that have less cardiotoxicity. Dexrazoxane, an iron chelator, and the radioprotective agent amifostine protect against cardiac injury, thus allowing the use of higher doses of anthracyclines. Other strategies that have been evaluated are dietary glutamine supplementation and the use of the antioxidant probucol.

Address: Department of Medicine, the Albert Einstein College of Medicine, Bronx, New York, USA.

DOI: 10.1097/00132580-200105000-00006

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MeSH Terms: Anthracyclines, Antibiotics, Antineoplastic, Carcinoma, Cardiotonic Agents, Cardiovascular System, Drug Therapy, Combination, Forecasting, Heart Diseases, Heart Failure, Humans, Monitoring, Physiologic, Neoplasms, Practice Guidelines as Topic, Radionuclide Angiography, Stroke Volume, Treatment Outcome, United States