Abstract
A 1-year-8-month-old boy with Down's syndrome developed acute megakaryoblastic leukemia. Chemotherapy consisted of eight courses of cytarabine (Ara-C), daunorubicin hydrochloride (DNR) and etoposide (VP-16). The total dosages of Ara-C, DNR and VP-16 were 5, 600 mg/m2, 480 mg/m2 and 3, 600 mg/m2, respectively. Complete remission was easily obtained. The ejection fraction (EF) remained at the normal level until 15 months after the cessation of chemotherapy. After he suffered from acute tonsillitis, his cardiac functions deteriorated. In spite of treatment with diuretics, an angiotensin-converting enzyme inhibitor, catecholamines and others, he died of cardiac failure, probably due to DNR-induced cardiomyopathy. In order to avoid DNR-induced cardiomyopathy, the total dosage of DNR should possibly be restricted to 350 mg/m2 or less.
