Key result
Anthracyclines cause cumulative dose-dependent cardiotoxicity, presenting primarily as heart failure or cardiomyopathy.
Why the study?
Anthracyclines are widely used antineoplastic agents that have improved survival in malignancies such as childhood cancers, but they can cause early or late cardiac toxicity presenting as heart failure, congestive cardiomyopathy, or arrhythmia.
Anthracycline antineoplastic agents improve cancer survival but carry a cumulative dose-dependent risk of cardiotoxicity manifesting primarily as congestive cardiomyopathy and heart failure.
Answers are grounded in this paper and cite their sources.
Anthracyclines remain central to childhood cancer survival with ongoing cardiac surveillance; leaves open optimal cardioprotection strategies for prospective trials.
The anthracyclines are effective and widely used antineoplastic agents.They are used to treat many types of malignancy including acute lymphoblastic leukaemia.'Their introduction has considerably improved survival, especially in childhood cancers.Signs of cardiac toxicity may develop during, soon after or many years after a course of treatment.Early toxicity is dependent principally on the cumulative anthracycline dose.Typically the patient presents with left ventricular or congestive heart failure and with clinical features of congestive cardiomyopathy.Less often an arrhythmia is the first manifestation of toxicity.The major differential diagnoses are malignant pericarditis, cardiac injury from concomitant radiotherapy, and coincidental heart muscle or coronary artery disease.The two most widely used and studied anthracyclines are daunorubicin and its C-14 derivative, doxorubicin (adriamycin).They are glycoside antibiotics that owe their anti- neoplastic action to a complex effect that results in inhibition of nucleic acid synthesis by binding to both strands of the DNA helix, preventing the normal function of RNA and DNA polymerases.
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Rhoden et al. (1993) conducted a review in Malignancy (including acute lymphoblastic leukaemia and childhood cancers) treated with anthracyclines. Anthracyclines (daunorubicin, doxorubicin) was evaluated on Cardiac toxicity (left ventricular or congestive heart failure, congestive cardiomyopathy, or arrhythmia). Anthracyclines (daunorubicin and doxorubicin) cause cumulative dose-dependent cardiac toxicity presenting primarily as congestive heart failure, cardiomyopathy, or less often arrhythmias.
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