Risk Factor Analysis for Secondary Malignancy in Dexrazoxane-Treated Pediatric Cancer Patients.
- Author:
Hyery KIM
1
;
Hyoung Jin KANG
;
Kyung Duk PARK
;
Kyung Nam KOH
;
Ho Joon IM
;
Jong Jin SEO
;
Jae Wook LEE
;
Nack Gyun CHUNG
;
Bin CHO
;
Hack Ki KIM
;
Jae Min LEE
;
Jeong Ok HAH
;
Jun Ah LEE
;
Young Ho LEE
;
Sang Kyu PARK
;
Hee Jo BAEK
;
Hoon KOOK
;
Ji Yoon KIM
;
Heung Sik KIM
;
Hwang Min KIM
;
Hee Won CHUEH
;
Meerim PARK
;
Hoi Soo YOON
;
Mee Jeong LEE
;
Hyoung Soo CHOI
;
Hyo Seop AHN
;
Yoshifumi KAWANO
;
Ji Won PARK
;
Seokyung HAHN
;
Hee Young SHIN
Author Information
- Publication Type:Original Article
- Keywords: Dexrazoxane; Childhood; Cancer; Anthracyclines; Risk factors; Second neoplasm
- MeSH: Anthracyclines; Cardiotoxicity; Dexrazoxane; Disease-Free Survival; Follow-Up Studies; Humans; Incidence; Korea; Multivariate Analysis; Neoplasms, Second Primary; Risk Factors*; Stem Cell Transplantation
- From:Cancer Research and Treatment 2019;51(1):357-367
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Dexrazoxane has been used as an effective cardioprotector against anthracycline cardiotoxicity. This study intended to analyze cardioprotective efficacy and secondary malignancy development, and elucidate risk factors for secondary malignancies in dexrazoxane-treated pediatric patients. MATERIALS AND METHODS: Data was collected from 15 hospitals in Korea. Patients who received any anthracyclines, and completed treatment without stem cell transplantation were included. For efficacy evaluation, the incidence of cardiac events and cardiac event-free survival rates were compared. Data about risk factors of secondary malignancies were collected. RESULTS: Data of total 1,453 cases were analyzed; dexrazoxane with every anthracyclines group (D group, 1,035 patients) and no dexrazoxane group (non-D group, 418 patients). Incidence of the reported cardiac events was not statistically different between two groups; however, the cardiac event-free survival rate of patients with more than 400 mg/m2 of anthracyclines was significantly higher in D group (91.2% vs. 80.1%, p=0.04). The 6-year cumulative incidence of secondary malignancy was not different between both groups after considering follow-up duration difference (non-D, 0.52%±0.37%; D, 0.60%±0.28%; p=0.55). The most influential risk factor for secondary malignancy was the duration of anthracycline administration according to multivariate analysis. CONCLUSION: Dexrazoxane had an efficacy in lowering cardiac event-free survival rates in patients with higher cumulative anthracyclines. As a result of multivariate analysis for assessing risk factors of secondary malignancy, the occurrence of secondary malignancy was not related to dexrazoxane administration.
