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Administration of Dexrazoxane Improves Cardiac Indices in Children and Young Adults With Acute Myeloid Leukemia (AML) While Maintaining Survival Outcomes. J Pediatr Hematol Oncol 2017 07;39(5):e254-e258 PMID: 28452856 PMCID: PMC5591641

Pubmed ID

28452856

DOI

10.1097/MPH.0000000000000838

Abstract

Anthracycline-induced cardiotoxicity remains a significant contributor to late morbidity/mortality in children and young adults with acute myeloid leukemia (AML). The cardioprotectant dexrazoxane can be used as prophylaxis to diminish risk for cardiomyopathy but whether it affects risk of relapse in pediatric AML is unclear. Our institution adopted the use of dexrazoxane before anthracyclines administration for all oncology patients in 2011. We compared patients with AML (ages, 0 to 21 y) who received or did not receive dexrazoxane during the years 2008 to 2013. In total, 44 patients with AML (ages, 4.5 mo to 21.7 y) were included. We identified no statistical difference in 2-year event rate (62% vs. 50%, P=0.41) or 2-year overall survival (69% vs. 69%, P=0.53) between patients receiving (n=28) or not receiving (n=16) dexrazoxane. Ejection fraction (P=0.0262) and shortening fraction (P=0.0381) trended significantly higher in patients that received dexrazoxane compared with those that did not receive dexrazoxane. Utilization of the cardioprotectant dexrazoxane before anthracycline chemotherapy in pediatric patients with AML demonstrated no significant difference in either event rate or overall survival relative to institutional controls and seems to improve cardiac function indices. Further studies in this patient population are needed to confirm these findings.

Author List

Schloemer NJ, Brickler M, Hoffmann R, Pan A, Simpson P, McFadden V, Block J, Tower RL 2nd, Burke MJ

Authors

Joseph Block MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin
Molly Brickler NP Nurse Practitioner in the Pediatrics department at Medical College of Wisconsin
Michael James Burke MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Vanessa Mcfadden MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin
Nathan Schloemer MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin
Pippa M. Simpson PhD Chief, Professor in the Pediatrics department at Medical College of Wisconsin
Richard L. Tower MD Associate Professor in the Pediatrics department at Medical College of Wisconsin




Scopus

2-s2.0-85021364265   3 Citations

MESH terms used to index this publication - Major topics in bold

Adolescent
Anthracyclines
Cardiomyopathies
Cardiotonic Agents
Child
Child, Preschool
Dexrazoxane
Heart Function Tests
Humans
Infant
Leukemia, Myeloid, Acute
Survival Rate
Young Adult
jenkins-FCD Prod-332 f92a19b0ec5e8e1eff783fac390ec127e367c2b5