Key result
High-dose cyclophosphamide therapy induced prolonged cardiotoxicity and heart failure in a 31-year-old woman, which was diagnosed via endomyocardial biopsy and required one year of conventional therapy to improve.
Case Report (n=1)
No
This case highlights that cyclophosphamide-induced cardiotoxicity can present with a prolonged clinical course and can be definitively diagnosed via endomyocardial biopsy.
May signal delayed cyclophosphamide cardiotoxicity after auto-transplant; leaves open optimal surveillance and biopsy indications in refractory lymphoma.
A 31-year-old woman with primary mediastinal large B-cell lymphoma refractory to conventional chemotherapy was treated with high-dose chemotherapy containing cyclophosphamide (CY). Subsequently, she was treated with auto peripheral blood stem cell transplantation. Although a complete remission was obtained, heart failure developed two months later. Echocardiography showed an impaired systolic function with pericardial effusion. A biopsy of the endomyocardial region from the left ventricle demonstrated spotty myocardial hemorrhage and myocardial fibrosis with disruption and aggregation of mitochondrial cristae. Based on these findings, CY-induced cardiotoxicity was diagnosed. The patient was treated with conventional therapy for heart failure, which required approximately one year to improve her condition.
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Kusumoto et al. (2013) conducted a case report in Cyclophosphamide-induced cardiotoxicity (n=1). High-dose cyclophosphamide was evaluated. High-dose cyclophosphamide therapy induced prolonged cardiotoxicity and heart failure in a 31-year-old woman, which was diagnosed via endomyocardial biopsy and required one year of conventional therapy to improve.
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