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Dexrazoxane Preserves Cardiac Function in Pediatric Leukemia

Beneficial for patients with AML receiving anthracyclines, with no impact on event-free, overall survival

sick child

TUESDAY, May 12, 2020 (HealthDay News) -- For pediatric patients with acute myeloid leukemia (AML), dexrazoxane preserves cardiac function without affecting survival, according to a study published online April 28 in the Journal of Clinical Oncology.

Kelly D. Getz, Ph.D., from the Children's Hospital of Philadelphia, and colleagues conducted a multicenter study of all pediatric patients with AML without high allelic ratio FLT3/ITD treated between 2011 and 2016. Patients were followed for a median of 3.5 years. Dexrazoxane was administered at the discretion of treating physicians; per protocol, anthracyclines were to be withheld if there was evidence of left ventricular systolic dysfunction (LVSD).

Data were included for 1,014 patients; 96 were dexrazoxane-exposed at every anthracycline course and 918 were never exposed. The researchers found significantly smaller ejection fraction and shortening fraction declines for dexrazoxane-exposed versus unexposed patients across courses; dexrazoxane-exposed patients also had a lower risk for LVSD (26.5 versus 42.2 percent; hazard ratio, 0.55; 95 percent confidence interval, 0.36 to 0.86; P = 0.009). Compared with unexposed patients, dexrazoxane-exposed patients had similar five-year event-free survival (49 versus 45.1 percent) and overall survival (65 versus 61.9 percent); there was a suggestion of lower treatment-related mortality with dexrazoxane (5.7 versus 12.7 percent).

"A more complete understanding of the underlying biology of anthracycline-associated cardiotoxicity and effective interventions will improve both the cardiovascular and oncologic outcomes for children with cancer," the authors write.

Bayer HealthCare Pharmaceuticals and Takeda Pharmaceuticals International provided study drugs.

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