Vnitr Lek 1994, 40(8):506-512

[Lower cardiotoxicity of adriamycin during continuous administration in patients with refractory multiple myeloma treated with cyclophosphamide, vincristine, adriamycin and dexamethasone (C-VAD)].

Z Adam, L Elbl, J Vorlícek, R Hájek, M Tomíska, N Hejlová, E Králová, H Novotná

II. interní klinika FN Brno.

Standard treatment of refractory myeloma is combined VAD treatment (vincristine, adriamycin and dexamethasone). In recent years adriamycin was sometimes replaced by mitoxanthrone which caused greater myelotoxicity. As a positive feature of the exchange of adriamycin for mitoxanthrone, authors using it, report its lower cardiotoxicity. In the literature there are, however, occasional reports on a lower cardiotoxicity of adriamycin when administered in a continuous infusion. In the submitted work the authors sought answers to two questions. 1. Is the cardiotoxicity of adriamycin administered in a continuous infusion lower than the cardiotoxicity of adriamycin administered as a bolus? 2. Is it possible to add to VAD chemotherapy cyclophosphamide without increasing the toxicity excessively? After echocardiographic evaluation of the diastolic and systolic function following a cumulative dose of 200 mg the authors observed smaller changes of the above functions in the group treated with adriamycin a in a continuous infusion (patients with multiple myeloma) than in the group with bolus therapy (patients with non-Hodgkin lymphomas and acute leukaemia). Addition of 600 mg cyclophosphamide on the 5th, 10th and 20th day to the classical VAD pattern made treatment more intensive without causing a deteriorated tolerance of this treatment.

Keywords: Aged; Antineoplastic Combined Chemotherapy Protocols, adverse effects, ; Cyclophosphamide, administration & dosage, ; Dexamethasone, administration & dosage, ; Doxorubicin, administration & dosage, ; Female; Heart, drug effects, ; Humans; Infusions, Intravenous; Male; Middle Aged; Multiple Myeloma, drug therapy, ; Vincristine, administration & dosage,

Published: August 1, 1994  Show citation