Key result
Adriamycin-based chemotherapy linked to lethal ventricular fibrillation one month post-treatment in osteogenic sarcoma.
Why the study?
Sudden cardiac death may occur following adjuvant chemotherapy with Adriamycin without antecedent cardiac failure, but clinical details are limited.
Case Report (n=1)
This case highlights the risk of sudden cardiac death from ventricular fibrillation associated with myocardial fibrosis following Adriamycin-based chemotherapy, even without antecedent heart failure.
Answers are grounded in this paper and cite their sources.
Alerts clinicians to late VF risk after Adriamycin even without heart failure; hypothesis-generating for fibrosis surveillance in survivors.
An 18-year-old man had had an osteogenic sarcoma of the distal tibia at age 16. Below-knee amputation was carried out and followed by adjuvant chemotherapy with Adriamycin, vincristine, methotrexate, Cytoxan, and melphalan. One month after termination of chemotherapy, he died suddenly while playing tennis. Documented ventricular fibrillation was unresponsive to cardiopulmonary resuscitation. Myocardial fibrosis ("cardiomyopathy") was the only significant anatomic finding at autopsy. The occurrence of sudden death without antecedent cardiac failure may have been related to strenuous physical activity in this patient who had received combined adjuvant chemotherapy.
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Couch et al. (1981) conducted a case report in Osteogenic sarcoma (n=1). Adriamycin-based adjuvant chemotherapy was evaluated on Sudden cardiac death. An 18-year-old man treated with Adriamycin-based chemotherapy for osteogenic sarcoma experienced sudden cardiac death due to ventricular fibrillation one month after completing therapy.
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