Anthracycline cardiotoxicity.

Full Abstract

The use of anthracyclines is limited by dose-dependent cardiotoxicity. Three forms of anthracycline cardiotoxicity are described; an immediate pericarditis-myocarditis syndrome, an early onset chronic progressive CHF developing during or shortly after therapy and late-onset cardiotoxicity presenting years following treatment. A number of risk factors have been reported, including; cumulative dose, administration schedule, mediastinal radiotherapy, old and young age, concurrent cardiovascular disease, combination therapy, gender, ethnicity and chromosomal abnormalities. Evaluation of left ventricular ejection fraction has been widely adopted as a means of monitoring and assessing anthracycline-induced cardiotoxicity. Biochemical markers and other techniques, such as endomyocardial biopsy, metaiodobenzylguanidine and indium-111-antimyosin scintigraphy are not routinely used. Methods employed to prevent cardiotoxicity include cumulative dose limitation, alteration of administration schedule, anthracycline analogues, liposomal formulations and the cardioprotective agent, dexrazoxane. With the growing number of paediatric malignancy survivors and the increasing use of anthracyclines in the adjuvant treatment of breast cancer, the cardiotoxicity associated with these agents will remain a formidable issue for physicians. Further work is required to identify patients at increased risk of cardiotoxicity and to develop novel methods of protecting and treating this adverse effect.

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Author information

Author/s: Jones, Robin L (RL); Swanton, Charles (C); Ewer, Michael S (MS);

Affiliation: Royal Marsden Hospital, Department of Medicine, Fulham Road, London, SW3 6JJ, UK. robin.jones(-atsign-)icr.ac.uk

Journal and publication information

Publication Type: Journal Article; Review

Journal: Expert opinion on drug safety (Expert Opin Drug Saf), published in England. (Language: eng)

Reference: 2006-Nov; vol 5 (issue 6) : pp 791-809

Dates: Created 2006/10/18; Completed 2007/01/08;

PMID: 17044806, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Anthracyclines - administration & dosage; adverse effects; therapeutic use
Antibiotics, Antineoplastic - administration & dosage; adverse effects; therapeutic use
Heart - drug effects

Heart - drug effects
Heart Diseases - chemically induced; prevention & control
Humans

Associated Chemicals: Anthracyclines (0) ; Antibiotics, Antineoplastic (0)

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