The Experts below are selected from a list of 67407 Experts worldwide ranked by ideXlab platform
Chul Won Choi - One of the best experts on this subject based on the ideXlab platform.
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Comparison of consolidation strategies in acute myeloid leukemia: high-dose cytarabine alone versus intermediate-dose cytarabine combined with Anthracyclines
Annals of Hematology, 2015Co-Authors: Ka Won Kang, Hwa Jung Sung, Yong Park, Chul Won ChoiAbstract:We compared the efficacy of high-dose cytarabine alone to that of intermediate-dose cytarabine combined with Anthracyclines as consolidation therapy. Patients enrolled in the Korea University acute myeloid leukemia (AML) registry received remission induction chemotherapy with the same standard induction regimen (idarubicin and cytarabine 3 + 7). Postremission therapy was performed for three or four cycles according to one of the following regimens: high-dose cytarabine (3 g/m2) or combination of intermediate-dose cytarabine (1 g/m2) with Anthracyclines (idarubicin or mitoxantrone). Among the 443 AML patients enrolled in the registry, 145 patients received consolidation chemotherapy. The median overall survival (OS) and relapse-free survival (RFS) in the high-dose cytarabine group were significantly longer than those in the Anthracycline combination group (OS, not reached vs. 16.6 months, p = 0.045; RFS, 38.6 months vs. 11.0 months, p = 0.011). The median duration of neutropenia was longer in the Anthracycline combination group than in the high-dose cytarabine group (8 vs. 10 days, p = 0.001). This study suggests that high-dose cytarabine consolidation may produce superior outcomes than combination treatment with intermediate-dose cytarabine and Anthracyclines and that the addition of Anthracyclines during AML consolidation has limited value as compared to cytarabine intensification.
Tomas G Neilan - One of the best experts on this subject based on the ideXlab platform.
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myocardial extracellular volume by cardiac magnetic resonance imaging in patients treated with Anthracycline based chemotherapy
American Journal of Cardiology, 2013Co-Authors: Tomas G Neilan, Otavio R Coelhofilho, Ravi V Shah, Jiazuo H Feng, Diego Penaherrera, Damien Mandry, Francois Pierremongeon, Bobak HeydariAbstract:We aimed to determine whether the myocardial extracellular volume (ECV), measured using T1 measurements obtained during cardiac magnetic resonance imaging were increased in patients treated with Anthracyclines. We performed cardiac magnetic resonance imaging and echocardiography and measured the ECV in 42 patients treated with Anthracyclines. The data from the cardiac magnetic resonance study were compared to those from healthy volunteers. The Anthracycline-treated cohort consisted of 21 men and 21 women with a mean age of 55 ± 17 years, who presented a median of 84 months after chemotherapy with a cumulative Anthracycline exposure of 282 ± 65 mg/m(2) and a mean left ventricular ejection fraction of 52 ± 12%. The ECV was elevated in the Anthracycline-treated patients compared to the age- and gender-matched controls (0.36 ± 0.03 vs 0.28 ± 0.02, p <0.001). A positive association was found between the ECV and left atrial volume (ECV vs indexed left atrial volume, r = 0.65, p <0.001), and negative association was found between the ECV and diastolic function (E' lateral, r = -0.64, p <0.001). In conclusion, the myocardial ECV is elevated in patients with previous Anthracycline treatment and is associated with the diastolic function and increased atrial volumes.
Steven E. Lipshultz - One of the best experts on this subject based on the ideXlab platform.
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Chemotherapy-induced cardiotoxicity in children
Expert Opinion on Drug Metabolism & Toxicology, 2017Co-Authors: Neha Bansal, Shahnawaz M. Amdani, Emma R. Lipshultz, Steven E. LipshultzAbstract:ABSTRACTIntroduction: With advances in clinical oncology, the burden of morbidity and mortality for cancer survivors due to the cardiac side effects of the chemotherapy is steadily increasing. Treatment-related cardiac damage is progressive and often irreversible. Primary prevention of cardiotoxicity during treatment is possible with strategies like limiting the cumulative Anthracycline dose, the use of Anthracycline structural analogs, and especially cardioprotective agents.Areas covered: This review covers the various cardiotoxic chemotherapeutic agents, the pathophysiology of cardiotoxicity due to Anthracyclines, and the clinical and subclinical presentations and progression of childhood Anthracycline cardiotoxicity. We also discuss preventive measures and strategies, especially the cardioprotectant agent dexrazoxane where there is strong evidence-based support for its use with Anthracycline chemotherapy. However, there is a paucity of evidence-based recommendations for diagnosing and treating cancer t...
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Anthracycline-Induced Cardiotoxicity: A Review of Pathophysiology, Diagnosis, and Treatment
Current Treatment Options in Cardiovascular Medicine, 2014Co-Authors: Vivian I. Franco, Steven E. LipshultzAbstract:Anthracyclines have been widely used in children and adults to treat hematologic malignancies, soft-tissue sarcomas, and solid tumors. However, Anthracyclines come with both short- and long-term cardiotoxic effects, ranging from occult changes in myocardial structure and function to severe cardiomyopathy and heart failure that may result in cardiac transplantation or death. Here, we review the progress made over the past two decades in understanding the molecular and genetic basis of Anthracycline-induced cardiotoxicity; detecting and monitoring myocardial dysfunction; using adjunct cardioprotectant therapies, such as dexrazoxane; and improving cardioprotection with agents such as liposomal and pegylated doxorubicin. Despite this increased understanding, preventing drug-induced cardiotoxicity while maintaining oncologic efficacy to achieve the highest quality of life over a lifespan remain cornerstones of successful Anthracycline chemotherapy during childhood.
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protecting against Anthracycline induced myocardial damage a review of the most promising strategies
British Journal of Haematology, 2005Co-Authors: Karlijn A Wouters, Leontien C M Kremer, Tracie L Miller, Eugene H Herman, Steven E. LipshultzAbstract:Over the last 40 years, great progress has been made in treating childhood and adult cancers. However, this progress has come at an unforeseen cost, in the form of emerging long-term effects of Anthracycline treatment. A major complication of Anthracycline therapy is its adverse cardiovascular effects. If these cardiac complications could be reduced or prevented, higher doses of Anthracyclines could potentially be used, thereby further increasing cancer cure rates. Moreover, as the incidence of cardiac toxicity resulting in congestive heart failure or even heart transplantation dropped, the quality and extent of life for cancer survivors would improve. We review the proposed mechanisms of action of Anthracyclines and the consequences associated with Anthracycline treatment in children and adults. We summarise the most promising current strategies to limit or prevent Anthracycline-induced cardiotoxicity, as well as possible strategies to prevent existing cardiomyopathy from worsening.
Bobak Heydari - One of the best experts on this subject based on the ideXlab platform.
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myocardial extracellular volume by cardiac magnetic resonance imaging in patients treated with Anthracycline based chemotherapy
American Journal of Cardiology, 2013Co-Authors: Tomas G Neilan, Otavio R Coelhofilho, Ravi V Shah, Jiazuo H Feng, Diego Penaherrera, Damien Mandry, Francois Pierremongeon, Bobak HeydariAbstract:We aimed to determine whether the myocardial extracellular volume (ECV), measured using T1 measurements obtained during cardiac magnetic resonance imaging were increased in patients treated with Anthracyclines. We performed cardiac magnetic resonance imaging and echocardiography and measured the ECV in 42 patients treated with Anthracyclines. The data from the cardiac magnetic resonance study were compared to those from healthy volunteers. The Anthracycline-treated cohort consisted of 21 men and 21 women with a mean age of 55 ± 17 years, who presented a median of 84 months after chemotherapy with a cumulative Anthracycline exposure of 282 ± 65 mg/m(2) and a mean left ventricular ejection fraction of 52 ± 12%. The ECV was elevated in the Anthracycline-treated patients compared to the age- and gender-matched controls (0.36 ± 0.03 vs 0.28 ± 0.02, p <0.001). A positive association was found between the ECV and left atrial volume (ECV vs indexed left atrial volume, r = 0.65, p <0.001), and negative association was found between the ECV and diastolic function (E' lateral, r = -0.64, p <0.001). In conclusion, the myocardial ECV is elevated in patients with previous Anthracycline treatment and is associated with the diastolic function and increased atrial volumes.
Ka Won Kang - One of the best experts on this subject based on the ideXlab platform.
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Comparison of consolidation strategies in acute myeloid leukemia: high-dose cytarabine alone versus intermediate-dose cytarabine combined with Anthracyclines
Annals of Hematology, 2015Co-Authors: Ka Won Kang, Hwa Jung Sung, Yong Park, Chul Won ChoiAbstract:We compared the efficacy of high-dose cytarabine alone to that of intermediate-dose cytarabine combined with Anthracyclines as consolidation therapy. Patients enrolled in the Korea University acute myeloid leukemia (AML) registry received remission induction chemotherapy with the same standard induction regimen (idarubicin and cytarabine 3 + 7). Postremission therapy was performed for three or four cycles according to one of the following regimens: high-dose cytarabine (3 g/m2) or combination of intermediate-dose cytarabine (1 g/m2) with Anthracyclines (idarubicin or mitoxantrone). Among the 443 AML patients enrolled in the registry, 145 patients received consolidation chemotherapy. The median overall survival (OS) and relapse-free survival (RFS) in the high-dose cytarabine group were significantly longer than those in the Anthracycline combination group (OS, not reached vs. 16.6 months, p = 0.045; RFS, 38.6 months vs. 11.0 months, p = 0.011). The median duration of neutropenia was longer in the Anthracycline combination group than in the high-dose cytarabine group (8 vs. 10 days, p = 0.001). This study suggests that high-dose cytarabine consolidation may produce superior outcomes than combination treatment with intermediate-dose cytarabine and Anthracyclines and that the addition of Anthracyclines during AML consolidation has limited value as compared to cytarabine intensification.