author_facet Creutzig, Ursula
Diekamp, Sylke
Zimmermann, Martin
Reinhardt, Dirk
Creutzig, Ursula
Diekamp, Sylke
Zimmermann, Martin
Reinhardt, Dirk
author Creutzig, Ursula
Diekamp, Sylke
Zimmermann, Martin
Reinhardt, Dirk
spellingShingle Creutzig, Ursula
Diekamp, Sylke
Zimmermann, Martin
Reinhardt, Dirk
Blood
Long Term Data on Anthracycline Cardiotoxicity in 547 Children with AML.
Cell Biology
Hematology
Immunology
Biochemistry
author_sort creutzig, ursula
spelling Creutzig, Ursula Diekamp, Sylke Zimmermann, Martin Reinhardt, Dirk 0006-4971 1528-0020 American Society of Hematology Cell Biology Hematology Immunology Biochemistry http://dx.doi.org/10.1182/blood.v108.11.2014.2014 <jats:title>Abstract</jats:title> <jats:p>Anthracyclines are effective antineoplastic drugs in acute mylogenous leukemia (AML) and dose intensity and cumulative doses are especially important. However, the use of anthracyclines is limited by cardiotoxicity, which occurs already at 300 mg/m2 cumulative doses (given as daunorubicin dosage) in children. To evaluate anthracycline-associated cardiomyopathy in pediatric AML-patients, the incidence of late clinical and subclinical cardiotoxicity (using echocardiography) was analysed in studies AML-BFM 93 and 98. Out of a total of 1,207 patients under 18 years, 547 (45%) patients were eligible for the analysis of late cardiotoxicity - de novo AML: 470 of 1,010 (46%), AML-Down syndrome: 69 of 121 (57%), secondary AML 8 of 76 (11%) -, median follow-up 5.3 years (0.8–11.7 years) after diagnosis. The cumulative dose of anthracyclines was risk-adapted between 300 and 450 mg/m2 or even higher in patients with secondary AML.</jats:p> <jats:p>Results: Late cardiomyopathy was seen in 16 patients, cumulative incidence (CI) after 11 years 5±1% (de novo patients: 4±1%), including 4 of 38 patients (10.5%) who suffered already from early cardiomyopathy. Nine of these 16 patients (CI 2.5±1%) showed clinical symptoms, with persistent abnormal shortening fraction in 5 of them, which led to death in one AML-Down syndrome patient. Late subclinical cardiomyopathy occurred temporarily in 7 patients. Late clinical cardiomyopathy mainly effected patients with a second anthracycline therapy (3 of 8 with AML as secondary malignancy) and those with early cardiotoxicity. Using anthracyclines risk-adapted or administering long-term infusion might have contributed to the low rate of cardiomyopathy in AML de novo patients.</jats:p> Long Term Data on Anthracycline Cardiotoxicity in 547 Children with AML. Blood
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title Long Term Data on Anthracycline Cardiotoxicity in 547 Children with AML.
title_unstemmed Long Term Data on Anthracycline Cardiotoxicity in 547 Children with AML.
title_full Long Term Data on Anthracycline Cardiotoxicity in 547 Children with AML.
title_fullStr Long Term Data on Anthracycline Cardiotoxicity in 547 Children with AML.
title_full_unstemmed Long Term Data on Anthracycline Cardiotoxicity in 547 Children with AML.
title_short Long Term Data on Anthracycline Cardiotoxicity in 547 Children with AML.
title_sort long term data on anthracycline cardiotoxicity in 547 children with aml.
topic Cell Biology
Hematology
Immunology
Biochemistry
url http://dx.doi.org/10.1182/blood.v108.11.2014.2014
publishDate 2006
physical 2014-2014
description <jats:title>Abstract</jats:title> <jats:p>Anthracyclines are effective antineoplastic drugs in acute mylogenous leukemia (AML) and dose intensity and cumulative doses are especially important. However, the use of anthracyclines is limited by cardiotoxicity, which occurs already at 300 mg/m2 cumulative doses (given as daunorubicin dosage) in children. To evaluate anthracycline-associated cardiomyopathy in pediatric AML-patients, the incidence of late clinical and subclinical cardiotoxicity (using echocardiography) was analysed in studies AML-BFM 93 and 98. Out of a total of 1,207 patients under 18 years, 547 (45%) patients were eligible for the analysis of late cardiotoxicity - de novo AML: 470 of 1,010 (46%), AML-Down syndrome: 69 of 121 (57%), secondary AML 8 of 76 (11%) -, median follow-up 5.3 years (0.8–11.7 years) after diagnosis. The cumulative dose of anthracyclines was risk-adapted between 300 and 450 mg/m2 or even higher in patients with secondary AML.</jats:p> <jats:p>Results: Late cardiomyopathy was seen in 16 patients, cumulative incidence (CI) after 11 years 5±1% (de novo patients: 4±1%), including 4 of 38 patients (10.5%) who suffered already from early cardiomyopathy. Nine of these 16 patients (CI 2.5±1%) showed clinical symptoms, with persistent abnormal shortening fraction in 5 of them, which led to death in one AML-Down syndrome patient. Late subclinical cardiomyopathy occurred temporarily in 7 patients. Late clinical cardiomyopathy mainly effected patients with a second anthracycline therapy (3 of 8 with AML as secondary malignancy) and those with early cardiotoxicity. Using anthracyclines risk-adapted or administering long-term infusion might have contributed to the low rate of cardiomyopathy in AML de novo patients.</jats:p>
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author Creutzig, Ursula, Diekamp, Sylke, Zimmermann, Martin, Reinhardt, Dirk
author_facet Creutzig, Ursula, Diekamp, Sylke, Zimmermann, Martin, Reinhardt, Dirk, Creutzig, Ursula, Diekamp, Sylke, Zimmermann, Martin, Reinhardt, Dirk
author_sort creutzig, ursula
container_issue 11
container_start_page 2014
container_title Blood
container_volume 108
description <jats:title>Abstract</jats:title> <jats:p>Anthracyclines are effective antineoplastic drugs in acute mylogenous leukemia (AML) and dose intensity and cumulative doses are especially important. However, the use of anthracyclines is limited by cardiotoxicity, which occurs already at 300 mg/m2 cumulative doses (given as daunorubicin dosage) in children. To evaluate anthracycline-associated cardiomyopathy in pediatric AML-patients, the incidence of late clinical and subclinical cardiotoxicity (using echocardiography) was analysed in studies AML-BFM 93 and 98. Out of a total of 1,207 patients under 18 years, 547 (45%) patients were eligible for the analysis of late cardiotoxicity - de novo AML: 470 of 1,010 (46%), AML-Down syndrome: 69 of 121 (57%), secondary AML 8 of 76 (11%) -, median follow-up 5.3 years (0.8–11.7 years) after diagnosis. The cumulative dose of anthracyclines was risk-adapted between 300 and 450 mg/m2 or even higher in patients with secondary AML.</jats:p> <jats:p>Results: Late cardiomyopathy was seen in 16 patients, cumulative incidence (CI) after 11 years 5±1% (de novo patients: 4±1%), including 4 of 38 patients (10.5%) who suffered already from early cardiomyopathy. Nine of these 16 patients (CI 2.5±1%) showed clinical symptoms, with persistent abnormal shortening fraction in 5 of them, which led to death in one AML-Down syndrome patient. Late subclinical cardiomyopathy occurred temporarily in 7 patients. Late clinical cardiomyopathy mainly effected patients with a second anthracycline therapy (3 of 8 with AML as secondary malignancy) and those with early cardiotoxicity. Using anthracyclines risk-adapted or administering long-term infusion might have contributed to the low rate of cardiomyopathy in AML de novo patients.</jats:p>
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spelling Creutzig, Ursula Diekamp, Sylke Zimmermann, Martin Reinhardt, Dirk 0006-4971 1528-0020 American Society of Hematology Cell Biology Hematology Immunology Biochemistry http://dx.doi.org/10.1182/blood.v108.11.2014.2014 <jats:title>Abstract</jats:title> <jats:p>Anthracyclines are effective antineoplastic drugs in acute mylogenous leukemia (AML) and dose intensity and cumulative doses are especially important. However, the use of anthracyclines is limited by cardiotoxicity, which occurs already at 300 mg/m2 cumulative doses (given as daunorubicin dosage) in children. To evaluate anthracycline-associated cardiomyopathy in pediatric AML-patients, the incidence of late clinical and subclinical cardiotoxicity (using echocardiography) was analysed in studies AML-BFM 93 and 98. Out of a total of 1,207 patients under 18 years, 547 (45%) patients were eligible for the analysis of late cardiotoxicity - de novo AML: 470 of 1,010 (46%), AML-Down syndrome: 69 of 121 (57%), secondary AML 8 of 76 (11%) -, median follow-up 5.3 years (0.8–11.7 years) after diagnosis. The cumulative dose of anthracyclines was risk-adapted between 300 and 450 mg/m2 or even higher in patients with secondary AML.</jats:p> <jats:p>Results: Late cardiomyopathy was seen in 16 patients, cumulative incidence (CI) after 11 years 5±1% (de novo patients: 4±1%), including 4 of 38 patients (10.5%) who suffered already from early cardiomyopathy. Nine of these 16 patients (CI 2.5±1%) showed clinical symptoms, with persistent abnormal shortening fraction in 5 of them, which led to death in one AML-Down syndrome patient. Late subclinical cardiomyopathy occurred temporarily in 7 patients. Late clinical cardiomyopathy mainly effected patients with a second anthracycline therapy (3 of 8 with AML as secondary malignancy) and those with early cardiotoxicity. Using anthracyclines risk-adapted or administering long-term infusion might have contributed to the low rate of cardiomyopathy in AML de novo patients.</jats:p> Long Term Data on Anthracycline Cardiotoxicity in 547 Children with AML. Blood
spellingShingle Creutzig, Ursula, Diekamp, Sylke, Zimmermann, Martin, Reinhardt, Dirk, Blood, Long Term Data on Anthracycline Cardiotoxicity in 547 Children with AML., Cell Biology, Hematology, Immunology, Biochemistry
title Long Term Data on Anthracycline Cardiotoxicity in 547 Children with AML.
title_full Long Term Data on Anthracycline Cardiotoxicity in 547 Children with AML.
title_fullStr Long Term Data on Anthracycline Cardiotoxicity in 547 Children with AML.
title_full_unstemmed Long Term Data on Anthracycline Cardiotoxicity in 547 Children with AML.
title_short Long Term Data on Anthracycline Cardiotoxicity in 547 Children with AML.
title_sort long term data on anthracycline cardiotoxicity in 547 children with aml.
title_unstemmed Long Term Data on Anthracycline Cardiotoxicity in 547 Children with AML.
topic Cell Biology, Hematology, Immunology, Biochemistry
url http://dx.doi.org/10.1182/blood.v108.11.2014.2014