TY - JOUR
T1 - Adriamycin cardiotoxicity
T2 - a survey of 1273 patients
AU - Praga, C.
AU - Beretta, G.
AU - Vigo, P. L.
AU - Lenaz, G. R.
AU - Pollini, C.
AU - Bonadonna, G.
AU - Canetta, R.
AU - Castellani, R.
AU - Villa, E.
AU - Gallagher, C. G.
AU - von Melchner, H.
AU - Hayat, M.
AU - Ribaud, P.
AU - De Wasch, G.
AU - Mattsson, W.
AU - Heinz, R.
AU - Waldner, R.
AU - Kolaric, K.
AU - Buehner, R.
AU - Ten Bokkel-Huyninck, W.
AU - Perevodchikova, N. I.
AU - Manziuk, L. A.
AU - Senn, H. J.
AU - Mayr, A. C.
PY - 1979
Y1 - 1979
N2 - Valuable information was collected on the medical history and clinical course of 1273 patients entered in clinical trials with Adriamycin (ADR) carried out in 12 European cancer centers. A coded patient form was used for the data collection carried out in each center by a qualified physician following a guideline which was discussed and accepted by all of the participants. The aim of the study was to define the incidence, characteristics, and possible co-factors of the cardiomyopathy (CMP) in patients treated with combination chemotherapy regimens including ADR. The mean total dose of ADR was 268 mg/m 2 (range, 15-1251 mg/m 2), and 5.1% of the patients received a total dose of > 550 mg/m 2. A 'definite' ADR-related CMP was observed in 1.7% of the cases; another 3% of the cases were reported as 'possible' ADR-CMP since the role played by the drug could not be clearly defined. 'Definite' ADR-CMP was fatal in eight patients (0.6%) while 'possible' ADR-CMP was fatal in 13 patients (1.0%). Among the possible co-factors examined, the following ones were found to be significantly associated with the occurrence of a 'defininte' ADR-CMP: (a) total dose of ADR; (b) vincristine when given both before and concomitantly with ADR; (c) bleomycin when given before ADR; and (d) radiotherapy to the mediastinum when given concomitantly with ADR. Furthermore, none of 182 patients receiving ADR by slow infusion developed a 'definite' ADR-CMP, while 2% of the patients treated by bolus injection did so. The occurrence of a 'possible' ADR-CMP was found to be significantly associated with two pre-existing pathologic conditions (electrocardiogram [ECG] abnormalities and hypertension) but not with the treatment-related co-factors for the 'definite' ADR-CMP mentioned above. Other variables examined, such as sex, age, cancer type, baseline liver function, and cyclophosphamide treatment, did not seem to influence the risk of ADR-CMP. Data on ECG changes occurring during ADR treatment were also reported and their incidence was found to be strictly related to the frequency of the ECG monitoring.
AB - Valuable information was collected on the medical history and clinical course of 1273 patients entered in clinical trials with Adriamycin (ADR) carried out in 12 European cancer centers. A coded patient form was used for the data collection carried out in each center by a qualified physician following a guideline which was discussed and accepted by all of the participants. The aim of the study was to define the incidence, characteristics, and possible co-factors of the cardiomyopathy (CMP) in patients treated with combination chemotherapy regimens including ADR. The mean total dose of ADR was 268 mg/m 2 (range, 15-1251 mg/m 2), and 5.1% of the patients received a total dose of > 550 mg/m 2. A 'definite' ADR-related CMP was observed in 1.7% of the cases; another 3% of the cases were reported as 'possible' ADR-CMP since the role played by the drug could not be clearly defined. 'Definite' ADR-CMP was fatal in eight patients (0.6%) while 'possible' ADR-CMP was fatal in 13 patients (1.0%). Among the possible co-factors examined, the following ones were found to be significantly associated with the occurrence of a 'defininte' ADR-CMP: (a) total dose of ADR; (b) vincristine when given both before and concomitantly with ADR; (c) bleomycin when given before ADR; and (d) radiotherapy to the mediastinum when given concomitantly with ADR. Furthermore, none of 182 patients receiving ADR by slow infusion developed a 'definite' ADR-CMP, while 2% of the patients treated by bolus injection did so. The occurrence of a 'possible' ADR-CMP was found to be significantly associated with two pre-existing pathologic conditions (electrocardiogram [ECG] abnormalities and hypertension) but not with the treatment-related co-factors for the 'definite' ADR-CMP mentioned above. Other variables examined, such as sex, age, cancer type, baseline liver function, and cyclophosphamide treatment, did not seem to influence the risk of ADR-CMP. Data on ECG changes occurring during ADR treatment were also reported and their incidence was found to be strictly related to the frequency of the ECG monitoring.
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M3 - Article
C2 - 455324
AN - SCOPUS:0018650543
VL - 63
SP - 827
EP - 834
JO - Cancer Treatment Reports
JF - Cancer Treatment Reports
SN - 0361-5960
IS - 5
ER -