Heart transplant in a childhood leukemia survivor: a case report.

OBJECTIVES: Children with acute leukemia often receive therapy that is potentially cardiotoxic. Development of irreversible cardiac impairment requiring heart transplant may appear many years after anticancer therapy. Other possible causes are discussed. MATERIAL AND METHODS: We describe a young leukemia survivor who developed severe heart failure needing a heart transplant. RESULTS: A 4-year-old boy was treated with standard doses of chemotherapy containing cardiotoxic daunorubicin and mitoxantrone, and later, with an allogeneic bone marrow transplant. Twelve years after the diagnosis of acute myeloid leukemia, and following a viral infection of an unknown cause, he developed symptoms of heart failure. Severe dilated cardiomyopathy; and severe, left ventricular dysfunction with ejection fraction of 12% were noted on echocardiography. The patient required a heart transplant 19 years after the diagnosis of leukemia. CONCLUSIONS: Cardiac failure may progressively occur in childhood leukemia survivors. Heart transplant is indicated in patients with refractory hemodynamic decompensation.

[Severe heart failure in consequence of late anthracycline-induced cardiotoxicity--case report]. / Tazké srdcové zlyhávanie ako prejav neskorej antracyklínovej kardiotoxicity--kazuistika.

BACKGROUND: Anthracyclines are known cardiotoxic agents. Anthracycline therapy increases the risk of long-term cardiac adverse effects in oncology patients. CASE REPORT: We report the case of a young male patient with severe congestive heart failure. The patient was treated for childhood acute myeloid leukemia by chemotherapy containing anthracyclines. Manifest dilated cardiomyopathy was developing ten years after the termination of chemotherapy with symptoms of left ventricular heart failure. Seventeen years following the end of cytostatic therapy the patient underwent heart transplantantation as ultimum refugium. CONCLUSIONS: Late cardiac complications may become a serious therapeutic problem. In such cases, the heart transplantation seems to be the only effective approach otherwise terminal forms of the heart failure.