Severe adriamycin cardiotoxicity at cumulative dose below 500 Mg/M2: case report and review of the literature

ABSTRACT

Adriamycin [doxorubicin hydrochloride], an anthracycline antibiotic originally isolated from the fungus Streptomyces peucetius, is an effective antineoplastic agent against many human neoplasms including leukemias, lymphomas, and many solid tumors such as soft-tissue sarcomas. The most serious and total dose-limiting toxicity of Adriamycin is a well-described cardiomyopathy which is thought to be secondary to myocardial damage produced by oxygen-free radical production generated by the drug. The incidence of Adriamycin-induced cardiac toxicity [AICT] is directly related to the cumulative dose of the drug and is rare at cumulative doses below 550 mg/m[2] of body surface area. In this report we describe a patient who developed severe Adriamycin-induced cardiomyopathy at a cumulative dose of less than 500 mg/m[2]. The possible role of other chemotherapeutic agents which the patient was also receiving is also discussed