Thomas X, Le Q H, Fiere D
Department of Hematology, Edouard Herriot Hospital, 69437 Lyon Cedex 03, France.
Ann Hematol. 2002 Sep;81(9):504-7. doi: 10.1007/s00277-002-0534-8. Epub 2002 Sep 21.
We describe three cases of acute promyelocytic leukemia (APL) with long-term disease-free survival who developed congestive heart failure (CHF) requiring cardiac transplantation. All three patients presented late-onset cardiotoxicity. Cardiac failure occurred progressively after 31-month, 32-month, and 14-month intervals, respectively, following completion of first anthracycline therapy. Cumulative anthracycline doses were 585 mg of daunorubicin and 64 mg of mitoxantrone in case 1, 1779 mg of daunorubicin in case 2, and 825 mg of daunorubicin in case 3. The questions relating to the pathogenesis of cardiac failure are discussed. We also discuss the prophylactic measures required for such treatment-related side effects.
我们描述了3例急性早幼粒细胞白血病（APL）患者，他们长期无病生存，但发生了需要心脏移植的充血性心力衰竭（CHF）。所有3例患者均出现迟发性心脏毒性。分别在首次蒽环类药物治疗结束后31个月、32个月和14个月后逐渐出现心力衰竭。病例1的累积蒽环类药物剂量为柔红霉素585 mg和米托蒽醌64 mg，病例2为柔红霉素1779 mg，病例3为柔红霉素825 mg。文中讨论了与心力衰竭发病机制相关的问题。我们还讨论了针对此类治疗相关副作用所需的预防措施。
