Format

Send to

Choose Destination
Cancer Res Treat. 2019 Jan;51(1):357-367. doi: 10.4143/crt.2017.457. Epub 2018 May 14.

Risk Factor Analysis for Secondary Malignancy in Dexrazoxane-Treated Pediatric Cancer Patients.

Author information

1
Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
2
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
3
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
4
Department of Pediatrics, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea.
5
Department of Pediatrics, Daegu Fatima Hospital, Daegu, Korea.
6
Department of Pediatrics, Korean Cancer Center Hospital, Seoul, Korea.
7
Department of Pediatrics, Hanyang University Medical Center, Hanyang University College of Medicine, Seoul, Korea.
8
Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
9
Department of Pediatrics, Chonnam National University Hwasun Hospital, Chonnam National University School of Medicine, Hwasun, Korea.
10
Department of Pediatrics, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
11
Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea.
12
Department of Pediatrics, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
13
Department of Pediatrics, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea.
14
Department of Pediatrics, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
15
Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.
16
Department of Pediatrics, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
17
Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
18
Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
19
Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea.

Abstract

PURPOSE:

Dexrazoxane has been used as an effective cardioprotector against anthracycline cardiotoxicity. This study intended to analyze cardioprotective efficacy and secondary malignancy development, and elucidate risk factors for secondary malignancies in dexrazoxane-treated pediatric patients.

Materials and Methods:

Data was collected from 15 hospitals in Korea. Patients who received any anthracyclines, and completed treatment without stem cell transplantation were included. For efficacy evaluation, the incidence of cardiac events and cardiac event-free survival rates were compared. Data about risk factors of secondary malignancies were collected.

RESULTS:

Data of total 1,453 cases were analyzed; dexrazoxane with every anthracyclines group (D group, 1,035 patients) and no dexrazoxane group (non-D group, 418 patients). Incidence of the reported cardiac events was not statistically different between two groups; however, the cardiac event-free survival rate of patients with more than 400 mg/m2 of anthracyclines was significantly higher in D group (91.2% vs. 80.1%, p=0.04). The 6-year cumulative incidence of secondary malignancy was not different between both groups after considering follow-up duration difference (non-D, 0.52%±0.37%; D, 0.60%±0.28%; p=0.55). The most influential risk factor for secondary malignancy was the duration of anthracycline administration according to multivariate analysis.

CONCLUSION:

Dexrazoxane had an efficacy in lowering cardiac event-free survival rates in patients with higher cumulative anthracyclines. As a result of multivariate analysis for assessing risk factors of secondary malignancy, the occurrence of secondary malignancy was not related to dexrazoxane administration.

KEYWORDS:

Anthracyclines; Cancer; Childhood; Dexrazoxane; Risk factors; Second neoplasm

PMID:
29764117
PMCID:
PMC6333985
DOI:
10.4143/crt.2017.457
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Publishing M2Community Icon for PubMed Central
Loading ...
Support Center