[Chemotherapeutics-induced heart failure]

Abstract

Background: Antineoplastic chemotherapy may induce acute or late side effects. Cytostatic-induced cardiomyopathy counts as one of the most dangerous side effects and has major implications for the use of anthracyclines. Since anthracyclines are widely employed and frequently indispensable cytostatics, it is important to elucidate the mechanisms and risk factors of the associated heart failure and develop preventive or interventional strategies.

Results: Anthracycline-induced cardiomyopathy has been reported in up to 85% of treated patients. Known risk factors are younger age, advanced age, female gender, preexisting cardiac illness, cardiac irradiation, and other concomitant cardiotoxic medications. Proposed preventive strategies include the development of new anthracyclines, longer anthracycline infusion times, liposomal anthracycline formulations, the application of the iron chelator dexrazoxane, and identification of predisposing gene variants.

Conclusion: Most promising preventive strategies include longer infusion times, liposomal formulations, and the administration of the iron chelator dexrazoxane.