Anthracycline cardiomyopathy in children Report of two cases

Abstract

Two children with leukemia are presented, each demonstrating an unusual aspect of anthracycline‐induced cardiomyopathy. In the first patient (a 7‐monthold female with acute monocytic leukemia) extremely young age and previous chemotherapy with a podophyllotoxin derivative, VP‐16, may have predisposed the patient to fatal congestive heart failure at a total Daunorubicin dose of only 225 mg/m2. In the second patient, a delay of 41/2 years was not sufficient in preventing congestive heart failure resulting from the administration of additional anthracycline chemotherapy. We conclude that extremely young age and, possibly, prior therapy with VP‐16 may be additional risk factors in the development of anthracycline cardiomyopathy. Also, we suggest that once an anthracycline agent has reached a toxic threshold for the myocardium, the heart may always be at risk to injury from additional Adriamycin or Daunorubicin therapy. Copyright © 1979 American Cancer Society