Anthracycline-induced cardiotoxicity in adult hematologic malignancies

Semin Oncol. 2006 Jun;33(3 Suppl 8):S22-7. doi: 10.1053/j.seminoncol.2006.04.021.

Abstract

Anthracyclines are a highly efficacious treatment for adult hematologic malignancies, including acute myeloid leukemia, acute lymphoblastic leukemia, multiple myeloma, Hodgkin's disease, and non-Hodgkin's lymphoma. The consequences of anthracycline-induced cardiotoxicity have obliged hematologists to set empirical dose limits, above which the cardiotoxic risk is deemed unacceptable. However, subclinical (and also clinical) cardiotoxicity occurs below these empirical doses and may begin to induce cardiac damage in an unpredictable and progressive manner after the first dose of treatment. As a result, treatment with anthracyclines may be withdrawn from patients prematurely or substituted with less efficacious alternative therapies. Through discontinuing further use of anthracyclines, relapsed patients previously treated with these agents may consequently be treated with second-line therapy that is less effective and possibly less well tolerated. Anthracycline-induced cardiotoxicity is potentially fatal and can significantly impair patients' quality of life, while also substantially increasing health care costs.

Publication types

  • Review

MeSH terms

  • Adult
  • Anthracyclines / adverse effects*
  • Antineoplastic Agents / adverse effects*
  • Cause of Death
  • Heart / drug effects*
  • Heart Diseases / chemically induced*
  • Heart Diseases / prevention & control
  • Hematologic Neoplasms / drug therapy*
  • Humans
  • Leukemia / drug therapy
  • Lymphoma / drug therapy
  • Multiple Myeloma / drug therapy
  • Retreatment

Substances

  • Anthracyclines
  • Antineoplastic Agents