Longitudinal Change in Cardiac Function After Doxorubicin and Dexrazoxane: A Report From Children's Oncology Group ALTE11C2.

What was studied

Smaller studies of childhood cancer survivors have tied dexrazoxane to better heart pumping. It is less clear if this holds in larger groups over time. It is also unclear how it affects screening rules for heart muscle disease. This analysis used heart ultrasound data from patients given doxorubicin. All but one of the trials assigned dexrazoxane or none by chance. Blinded central remeasurement was used when possible.

What they found

The analysis covered 895 patients, with a mean follow-up of 5.9 years. Heart pumping was better kept with dexrazoxane, by a z-score gap of 0.4. It also went with lower hazards of reduced LV function. Hazard ratios were 0.58 at 1 year and 0.54 at 5 years. In high-risk patients by screening rules, it appeared to lower such events. Events per 1,000 person-years fell from 40 to 21.8.

What it means for patients

The authors say dexrazoxane has a significant, long-term heart-protective effect against doxorubicin. They say it may reduce the need for screening.

Why it is not certain yet

One of the protocols did not randomize dexrazoxane. Some echocardiogram data came from institutional reports, not central remeasurement. The results are links, after adjusting for age, sex, dose, chest radiation, and data type.

Source

Longitudinal Change in Cardiac Function After Doxorubicin and Dexrazoxane: A Report From Children's Oncology Group ALTE11C2.

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