Key result
A patient treated with 465 mg/m2 of doxorubicin for childhood leukemia developed progressive heart failure, required a heart transplant at age 36, and subsequently suffered sudden cardiac death.
Case Report (n=1)
This case illustrates the severe, lifelong trajectory of anthracycline-induced cardiotoxicity, progressing from early heart failure to end-stage dilated cardiomyopathy requiring transplantation decades later.
Supports lifelong surveillance in anthracycline-exposed survivors; leaves open optimal prevention and monitoring strategies.
In 1977, a 5-year-old girl diagnosed with acute lymphoblastic leukemia was treated on Dana-Farber Cancer Institute Childhood Acute Lymphoblastic Leukemia Protocol 77-01, receiving a cumulative doxorubicin dose of 465 mg/m(2), cranial radiation, and other drugs. After being in continuous complete remission for 34 months, she developed heart failure and was treated with digoxin and furosemide. At 16 years of age, she was diagnosed and treated for dilated cardiomyopathy. Over the years, she continued to have bouts of heart failure, which became less responsive to treatment. At 36 years of age, she received a heart transplant. Six months later, she stopped taking her medications and suffered a sudden cardiac death.
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Goldberg et al. (2012) conducted a case report in Acute lymphoblastic leukemia (n=1). Doxorubicin was evaluated. A patient treated with 465 mg/m2 of doxorubicin for childhood leukemia developed progressive heart failure, required a heart transplant at age 36, and subsequently suffered sudden cardiac death.
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