Cardiotoxicity of Mitoxantrone Treatment in a German Cohort of 639 Multiple Sclerosis Patients.
10.3988/jcn.2014.10.4.289
- Author:
Vinzenz FLEISCHER
1
;
Anke SALMEN
;
Susanne KOLLAR
;
Veronika WEYER
;
Volker SIFFRIN
;
Andrew CHAN
;
Frauke ZIPP
;
Felix LUESSI
Author Information
1. Department of Neurology, Focus Program Translational Neuroscience, Rhine Main Neuroscience Network, University Medical Center, Johannes Gutenberg University of Mainz, Mainz, Germany. luessi@uni-mainz.de
- Publication Type:Multicenter Study ; Original Article
- Keywords:
multiple sclerosis;
mitoxantrone;
cardiotoxicity;
dose dependency
- MeSH:
Cohort Studies*;
Follow-Up Studies;
Germany;
Heart Failure;
Hospital Records;
Humans;
Mitoxantrone*;
Multiple Sclerosis*;
Retrospective Studies;
Risk Assessment;
Risk Factors
- From:Journal of Clinical Neurology
2014;10(4):289-295
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND PURPOSE: The aim of this study was to elucidate the role of therapy-related cardiotoxicity in multiple sclerosis (MS) patients treated with mitoxantrone and to identify potential predictors for individual risk assessment. METHODS: Within a multicenter retrospective cohort design, cardiac side effects attributed to mitoxantrone were analyzed in 639 MS patients at 2 MS centers in Germany. Demographic, disease, treatment, and follow-up data were collected from hospital records. Patients regularly received cardiac monitoring during the treatment phase. RESULTS: None of the patients developed symptomatic congestive heart failure. However, the frequency of patients experiencing cardiac dysfunction of milder forms after mitoxantrone therapy was 4.1% (26 patients) among all patients. Analyses of the risk for cardiotoxicity revealed that cumulative dose exposure was the only statistically relevant risk factor associated with cardiac dysfunction. CONCLUSIONS: The number of patients developing subclinical cardiac dysfunction below the maximum recommended cumulative dose is higher than was initially assumed. Interestingly, a subgroup of patients was identified who experienced cardiac dysfunction shortly after initiation of mitoxantrone and who received a low cumulative dose. Therefore, each administration of mitoxantrone should include monitoring of cardiac function to enhance the treatment safety for patients and to allow for early detection of any side effects, especially in potential high-risk subgroups (as determined genetically).
