Dexrazoxane significantly reduced rates of electrocardiogram and echocardiogram abnormalities in pediatric ALL patients, indicating improved cardioprotection without increased adverse reactions.
Does dexrazoxane reduce anthracycline-induced cardiotoxicity in pediatric patients with acute lymphoblastic leukemia?
The addition of dexrazoxane to anthracycline-based induction chemotherapy in pediatric ALL significantly reduces early subclinical markers of cardiotoxicity without increasing adverse reactions.
Absolute Event Rate: 0% vs 0%
Abstract Objective This ambispective cohort study evaluates the effectiveness of cardioprotective strategies in reducing anthracycline-induced cardiotoxicity in pediatric patients with acute lymphoblastic leukemia (ALL). Methods We conducted a single-center, historically controlled ambispective cohort study at Kunming Children’s Hospital. Children with newly diagnosed ALL treated with the CCLG-ALL2018 protocol between May 2018 and May 2020 comprised the retrospective historical control cohort (no dexrazoxane). After institutional adoption of dexrazoxane, consecutive eligible patients treated between May 2020 and May 2022 were prospectively enrolled and followed according to a prespecified cardiac monitoring schedule. The exposure (use of dexrazoxane) was determined by calendar time rather than randomization. Results The combination therapy group exhibited significantly lower rates of electrocardiogram and echocardiogram abnormalities ( P < 0.01 and P < 0.01, respectively), suggesting a notable cardioprotective effect. Although baseline cardiac markers did not show significant differences between the groups, post-treatment levels of cardiac troponin T were significantly improved in the combination therapy group ( P < 0.05). Additionally, trends toward improved left ventricular ejection fraction and Creatine Kinase-Myocardial Band levels were observed, although these did not reach statistical significance. Importantly, the use of the cardioprotective agent did not lead to a significant increase in adverse reactions. Conclusion Incorporating a cardioprotective strategy into pediatric ALL treatment protocols appears to lower the risk of anthracycline-induced cardiotoxicity without compromising safety, hence boosting patient outcomes. These findings should be interpreted in light of the historically controlled, nonrandomized design and potential time-related confounding.
Liu et al. (Fri,) reported a other. Dexrazoxane significantly reduced rates of electrocardiogram and echocardiogram abnormalities in pediatric ALL patients, indicating improved cardioprotection without increased adverse reactions.