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Thread: Have you dealt with cardiotoxcicity concerns from chemo - doxorubicin, etc.

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    Have you dealt with cardiotoxicty concerns from chemo - doxorubicin, etc.

    Hello,

    I am wondering if anyone here has dealt with cardiotoxicity concerns from Doxorubicin/Adriamycin, etc. These drugs have a lifetime limit over which they start worrying about the effects to the heart and don't like to go over 300 mg/m2 lifetime.

    In brief, my son was misdiagnosed with a T-Cell cancer and given the chemo regimine for that cancer (CHOP, which contains doxorubicin), relapsed and had another biopsy which showed the misdiagnosis - it's actually Hodgkin's. The biggest issue is the gold standard regimine for Hodgkin's (80-90% cure rate) also contains doxorubicin. Together, he would be over the lifetime cap and they are telling us he can't have ABVD as it would be about 600 (total for both). But we're not going down without a fight!

    I have been researching possible ways to mitigate the cardiotoxic effects of Doxorubicin and most of the studies are on breast cancer, so I wanted to post here to see if anyone has dealt with this and might have some insight. Here's what I found:

    1) Pegylated Doxirubicin (Doxil) is well studied and much less cardiotoxic, but confers a 50% chance of Chemotherapy-induced acral erythema also known as palmar-plantar erythrodysesthesia or foot and hand sydrome, while generally resolves in 2-3 weeks after stopping chemo, it can be totally debilitating. Myocet is a liposomal preparation that is not pegylated and does not have that side effect but unfortunately it is only approved in Canada and Europe! 2) Alternate scheduling techniques such as in-hospital slow continuous drip over 48 hours reduces cardiotoxicity but is impractical and expensive 3) Cardioprotective drugs such as Doxrazoxane.

    Would greatly appreciate any insight if anyone has dealt with this concern.

    Thanks so much - VMarie
    Last edited by VMarie; 06-16-2017 at 04:46 PM.
    Researcher, advocate, and caregiver to my son, age 24
    July 2016, Diagnosed with Systemic ALCL ALK-neg, DUSP-neg, stage IV, IPI 2, PIT 1, normal LDH, normal B2 microglobulin
    Sept 2016, Third round of E-CHOP complete;; PET scan NED
    Nov 2016, Sixth and final round of E-CHOP completed
    Primary side effects: Some mucositis and constipation, but this resolved early on. Fatigue. Thrush after chemo resolved with Nystatin. Depression (also an issue before cancer diagnosis).
    Continued to live alone and work two jobs through chemo!
    Dec 2016, PET scan NED
    March 2017, Experiencing symptoms: cough and stomach issues. Found two small lumps in neck
    March 2017, CT scan shows relapse. Confirmed by PET
    April 2017, CD-30 confirmed with biopsy; Begin Brentuximab for at least three cycles
    May 2017, Biopsy came back with new diagnosis: Classical Hodgkin's! Likely misdiagnosed initially (by three different pathologists).

 

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