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Heart Drug May Help Children Treated for Leukemia

By Cheryl Simon Silver

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Drugs
Heart Disease
Leukemia and Lymphoma

A new study suggests that adding a second drug to standard therapies for acute lymphocytic leukemia (ALL) may reduce or avoid heart damage, a frequent and serious side effect among children treated for this cancer.

Researchers led by Stephen Lipshultz at Dana-Farber Cancer Institute in Boston , Massachusetts , report in the New England Journal of Medicine that the drug dexrazoxane reduces or prevents damage to heart muscle that can be caused by the most common and effective drug used to treat ALL. Dexrazoxane (sold as Zinecard) has been prescribed to limit heart damage caused by cancer treatments.

The cancer drug doxorubicin (used to treat ALL and sold as Adriamycin) can damage heart muscle because when the body breaks down the drug, cells produce free radicals—highly reactive molecules that damage cells.

The scientists found that when children took the two drugs in combination, fewer of them experienced elevated levels of a blood protein that indicate injury to heart muscle. The cancer drug was just as effective when given in combination with the heart drug.

The combination therapy reduced the incidence of heart damage to 25 percent from about 50 percent, according to Stephen R. Sallan, chief of staff at Dana-Farber and an author of the study.

In the last decade, treatment for childhood ALL, the most common childhood leukemia, has become standardized and highly effective. The treatments target cancer cells, but they also kill or damage normal cells, which leave some cancer patients vulnerable to future side effects such as congestive heart failure or arrhythmias—and a high risk of dying from heart disease.

A commentary in the New England Journal notes that the study “is an important step toward effective cardioprotection in children.”

See Related GNN Story: Genetic Damage from Leukemia Drugs Persists among Children

Lipshultz, S. E. et al. The Effect of Dexrazoxane of Myocardial Injury in Doxorubicin-Treated Children with Acute Lymphoblastic Leukemia. New England Journal of Medicine 351, 145-153 (July 8, 2004).
Kremer, L. and Caron, H. Anthracycline Cardiotoxicity in Children. New England Journal of Medicine 351, 120-121 (July 8, 2004).

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