Daunomycin-induced cardiotoxicity in children and adults. A review of 110 cases

Am J Med. 1977 Feb;62(2):200-8. doi: 10.1016/0002-9343(77)90315-1.


Daunomycin, like its anthracycline analog adriamycin, is a cardiotoxic antitumor antibiotic. Reports on 5,613 patients receiving daunomycin were reviewed for cardiotoxicity. Two distinct patterns of cardiotoxicity were defined, congestive heart failure (cardiomyopathy) and electrocardiographic changes. Dose-response curves were constructed using the percent incidence of cardiomyopathy versus the total dose of daunomycin in mg/m2. There was a dose-response relationship between the total dose of daunomycin and the development of cardiomyopathy, both in children and adults. The children seem more susceptible to the drug-induced cardiomyopathy. The electrocardiographic changes in the children and adults did not show a dose-dependent relationship, were present consistently even at the lowest dosage levels, and did not predict for subsequent development of cardiomyopathy. The dose-response curves constructed enable the clinician to judge the relative risk of developing cardiomyopathy at a given total dosage level and allows comparison of the human experience with the experimental animal model data.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Arrhythmias, Cardiac / chemically induced*
  • Child
  • Child, Preschool
  • Daunorubicin / adverse effects*
  • Dose-Response Relationship, Drug
  • Electrocardiography
  • Heart Failure / chemically induced*
  • Humans
  • Maryland
  • Middle Aged
  • Retrospective Studies
  • Time Factors


  • Daunorubicin