Department of Cardiology, Institute of Biomedical Research and Innovation, 2-2 Minatojima Minamimachi Chuoku, Kobe 650-0047, Japan.
J Cardiol. 2009 Oct;54(2):330-4. doi: 10.1016/j.jjcc.2009.01.006. Epub 2009 Feb 20.
A 59-year-old male with an abdominal mass that showed a diffuse large B cell lymphoma underwent extirpation of the tumor and chemotherapy. He subsequently received high-dose chemotherapy containing cyclophosphamide (1.5 g/m(2)/day x 2 days), followed by autologous peripheral blood stem cell transplantation. He developed congestive heart failure 5 days after administration of cyclophosphamide. His electrocardiogram showed extremely low voltage with ST segment change and echocardiogram showed diffusely increased left ventricular wall thickness, an increase in myocardial echogenicity, pericardial effusion, and generally decreased systolic function. Congestive heart failure progressed rapidly and he died the following day. Post-mortem examination of the heart revealed myocardial hemorrhage, yellowish brown pericardial effusion, and fibrinous pericarditis. His liver was atrophic and focal necrosis was observed histologically. Cyclophosphamide-induced cardiotoxicity occurred, even though the patient had both shown normal cardiac function before high-dose chemotherapy and had received a lower dose of cyclophosphamide. Concomitant administration of cytarabine might have affected his liver function and there might have been interaction between the drugs.
一位 59 岁男性因腹部肿块被诊断为弥漫性大 B 细胞淋巴瘤，接受了肿瘤切除术和化疗。随后，他接受了含有环磷酰胺（1.5 g/m(2)/天 x 2 天）的大剂量化疗，随后进行了自体外周血干细胞移植。环磷酰胺给药后 5 天出现充血性心力衰竭。他的心电图显示极低电压伴有 ST 段改变，超声心动图显示弥漫性左心室壁增厚，心肌回声增强，心包积液，收缩功能普遍降低。充血性心力衰竭迅速进展，次日死亡。心脏尸检显示心肌出血、黄褐色心包积液和纤维性心包炎。他的肝脏萎缩，组织学观察到局灶性坏死。尽管该患者在大剂量化疗前表现出正常的心脏功能，并接受了较低剂量的环磷酰胺，但仍发生了环磷酰胺诱导的心脏毒性。阿糖胞苷的联合给药可能影响了他的肝功能，并且药物之间可能存在相互作用。
