Protect the heart during AML treatment with dexrazoxane

Using dexrazoxane can provide effective cardioprotection in children with acute myeloid leukemia (AML), according to a new study in the Journal of Clinical Oncology.¹

The study was a multicenter study of all patients with AML but without high allelic ratio FLT3/ITD who were treated in Children’s Oncology Group trial AAML1031 between 2011 and 2016. The median length of follow-up was 3.5 years. The administration of dexrazoxane was done at the discretion of treating physicians and was documented at each course.

A total of 1014 patients were included in the study and 96 were give dexrazoxane at every anthracycline course. Compliance with cardiac monitoring, treatment arm, presenting white blood count, sex, race, and age had similar distributions among dexrazoxane-exposed and unexposed patients. Investigators found that dexrazoxane-exposed patients had significantly smaller declines in ejection fraction and shortening fraction than patients who had no exposure as well as a lower risk of left ventricular systolic dysfunction. The 5-year event free survival and overall survival was the same between the exposed group and the unexposed group, with a suggestion of lower treatment-related mortality among patients with dexrazoxane.

The researchers concluded that dexrazoxane worked to preserve cardiac function in children with AML without increasing noncardiac toxicity and should be kept in consideration for cardioprotection during treatment of AML.

References:

1.    Getz KD, Sung L, Alonzo TA, Leger KJ, Gerbing RB, Pollard JA. Effect of dexrazoxane on left ventricular systolic function and treatment outcomes in patients with acute myeloid leukemia: a report from the Children's Oncology Group. J Clin Oncol. April 28, 2020. Epub ahead of print. doi: 10.1200/JCO.19.02856