Subclinical anthracycline cardiotoxicity in patients with acute promyelocytic leukemia in long-term remission after the AIDA protocol.

Abstract

Anthracycline chemotherapy remains a critical component of cancer treatment despite its established risk of cardiotoxicity. To investigate whether the AIDA protocol, which combines idarubicin, mitoxantrone, and all-trans retinoic acid (ATRA) for treatment of acute promyelocytic leukemia (APL) results in late cardiotoxicity, 34 APL patients in long-term remission were evaluated. The cumulative dose of idarubicin and mitoxantrone were 80 mg/m(2) and 50 mg/m(2), respectively. Median follow-up was 7 years. Segmental wall motion abnormalities (SWMAs) were detected in 11 AIDA patients who still presented with an ejection fraction (EF) within normal limits (EF 56% in the AIDA group vs 59% in the control group, P=.01). However, parameters of diastolic dysfunction were significantly impaired in the AIDA group (E/A ratio: 1.04 in the AIDA group vs 1.28 in the control group, P=.001; E/E' lateral ratio: 10.04 in the AIDA group vs 5.79 in the control group, P≤.001) as well as left atrial volume (52 mL in the AIDA group vs 35 mL in the control group, P<.001). Cardiac toxicity due to anthracycline therapy is often frequent. Changes in diastolic function are helpful in the detection of subclinical anthracycline cardiotoxicity in long-term cardiac follow-up despite a preserved systolic ventricular function.

• Authors: Pierpaolo Pellicori, Angela Calicchia, Francesco Lococo, Giuseppe Cimino, Concetta Torromeo
• Journal: Congestive heart failure (Greenwich, Conn.) (Congest Heart Fail) 2012 Jul-Aug Vol. 18 Issue 4 Pg. 217-21 ISSN: 1751-7133 [Electronic] United States
• PMID: 22809260 (Publication Type: Journal Article)
• Copyright: © 2011 Wiley Periodicals, Inc.

Chemical References

• Anthracyclines
• Antibiotics, Antineoplastic
• Cardiotoxins
• Tretinoin
• Mitoxantrone
• Idarubicin

Topics

• Adult
• Anthracyclines (adverse effects)
• Antibiotics, Antineoplastic (adverse effects)
• Antineoplastic Combined Chemotherapy Protocols (adverse effects)
• Cardiotoxins (adverse effects)
• Diastole
• Female
• Humans
• Idarubicin (adverse effects)
• Leukemia, Promyelocytic, Acute (complications)
• Male
• Middle Aged
• Mitoxantrone (adverse effects)
• Prospective Studies
• Risk Factors
• Systole
• Time Factors
• Tretinoin (adverse effects)
• Young Adult