How to Protect a Soft Heart

Leukemia treatments in children evidence for use of dexrazoxane to protect heart from damage

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) The legacy of childhood cancer, in addition to never being quite sure if the cancer is gone for good, also includes the literal scars from treatment.

Several types of chemotherapy for leukemia concentrate in the blood, and since the toxic compounds are in frequent contact with the constantly working muscle of the heart, it is a particularly striking victim of collateral damage.

"Ask your oncologist about permanent side effects."

Researchers from the University of Rochester found that adding Zinecard (dexrazoxane) prevented the most significant effects of chemotherapy treatment using Adriamycin / Rubex (doxorubicin) in acute lymphoblastic leukemia.

While Adriamycin is a very effective type of chemotherapy for treating leukemia, it comes with the unfortunate side effect of causing enlargement of the heart, and at times alters the structure of the heart muscle.

Formerly, evidence in women given chemotherapy to treat breast cancer showed clear protective effects when Zinecard was used, but the trade-off seemed to be a very slight risk in new kinds of cancer forming.

Barbara Asselin, MD and the first author of the study, said it was debatable whether the increase in new cancers in patients treated with Zinecard was enough to be statistically significant or was just random chance, but said it would be examined in future clinical testing.

Testing took place between 1996 and 2001 with 537 children with leukemia split into two treatment groups, standard chemotherapy with or without Zinecard.

Out of the 13 patients in the study who developed secondary cancers, 10 were in the Zinecard group. Side effects reported during the study were severe, but at a level consistent with the documented research on the chemotherapy drugs.

"Today the majority of children with leukemia will be cured," Asselin said. "As our young people survive, though, we believe we will see many more cardiac issues. It is a problem that must be fixed because it is the leading cause of death later in life among these patients."

"We now have some very effective cancer treatments at our disposal," Dr. Asselin stated. "But we really need to focus on promoting the good health of our survivors. Our care does not end with chemotherapy. Being there for many years into the future, and to help childhood survivors understand their risks, is so important."

Studies presented at conference, as well as their conclusions, should be considered preliminary findings until publication in a peer-reviewed journal.

The study was sponsored by the Children's Oncology Group and the National Cancer Institute.

Reviewed by: 
Review Date: 
June 15, 2012
Last Updated:
November 8, 2012