2023 Volume 60 Issue 1 Pages 15-19
Background: Dexrazoxane is reported to reduce anthracycline-induced myocardial damage. Under institutional review board approval, we introduced dexrazoxane combined with anthracycline chemotherapy to determine the short- and middle-term safety of Japanese childhood cancer patients who require high-cumulative anthracycline exposure. Methods: Dexrazoxane was administered at a 10-fold dose of the planned anthracycline dose by 15 min injection immediately followed anthracycline administration. Other therapies were carried out as usual. Before dexrazoxane treatment, informed consent was obtained from their guardians. Results: Thirty-eight children (20 males and 18 females) were treated with dexrazoxane from February 2015 to January 2022. The diagnoses were brain tumors in 9, solid tumors in 25, and hematological malignancies in 4 patients. Their median age at their first dexrazoxane treatment was 4 years and 2 months. Eleven patients received stem cell transplantation (allogeneic in 3 and autologous in 8), and six patients received living-donor liver transplantation. The median cumulative anthracycline dose at the start of dexrazoxane treatment was 260 mg/m2, and at the last treatment, it was 375 mg/m2. There was no adverse event due to dexrazoxane during their treatment. Bone marrow suppression periods and organ function seemed to be unaffected. The median observational period of the 38 patients was 657 days. So far, no one has developed heart failure or secondary cancer. Four patients died due to their cancer. The long-term heart-protective and adverse effects of dexrazoxane need to be evaluated with a longer follow-up period. Conclusion: Dexrazoxane can be used safely without any acute adverse effects on anthracycline chemotherapy among Japanese children with cancer.
