Nížší kardiotoxicita adriamycinu během nepřetržitého dávkování u pacientů s refrakterním mnohočetným myelomem léčeným cyklofosfamidem, vinkristinem, adriamycinem a dexametasonem (C-VAD)

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

ADAM Zdeněk ELBL L. VORLÍČEK Jiří HÁJEK Roman TOMÍŠKA Miroslav HEJLOVÁ N. KRÁLOVÁ E. NOVOTNÁ H.

Year of publication 1994
Type Article in Periodical
Magazine / Source Vnitřní lékařství
MU Faculty or unit

Faculty of Medicine

Citation
Field Oncology and hematology
Keywords multiple myeloma; vincristine; dexamethasone; adriamycin; cyclophosphamide
Description 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.

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