Myocardial injury produced by antineoplastic drugs.

Histologic and ultrastructural studies were performed on the heart of 16 patients with fatal leukemias or solid tumors. Multifocal myocardial degenerative lesions, characterized by alterations in contractile elements, mitochondria, and nuclei, were found in 12 patients treated with high total doses of anthracyclines, but not in 3 patients who did receive such therapy. One patient who received a high dose of cyclophosphamide as well as a high total dose of daunorubicin exhibited extensive hemorrhagic myocardial necrosis and multifocal degenerative lesions. This study documents the cardiotoxic effects of anthracyclines and cyclophosphamide.