Effect of digoxin and vitamin E in preventing cardiac damage caused by doxorubicin in acute myeloid leukaemia

Abstract

The authors studied 63 patients with newly diagnosed acute myeloid leukaemia but without known heart disease who had not previously received digoxin. Systolic time intervals provide a simple yet sensitive measurement of myocardial damage and have been used previously to assess patients receiving doxorubicin. Our results show that doxorubicin may be given safely to a high total dosage if systolic time intervals are monitored regularly. Although nine patients showed evidence of heart damage, we were able to continue using doxorubicin in their treatment with frequent monitoring of the ratio of the preejection period to the left ventricular ejection time. Three patients (one of whom had mild clinical left ventricular failure) showed progressive increases in this ratio, which returned slowly to normal when doxorubicin was stopped. The search for anthracycline drugs that do not cause cardiac damage continues, but for the moment it seems prudent to treat patients receiving anthracyclines with digoxin and to monitor their cardiac function carefully by measuring systolic time intervals or by echocardiography.