Increased serum cTnT level can be detected in the early stages of anthracycline therapy and it is associated with diastolic dysfunction of the left ventricle. Therefore, serum cTnT level could be a useful measure for early detection of anthracycline-induced cardiotoxicity.

Doxorubicin may result in arrhythmias both in early and late periods of treatment. These arrhythmias are rarely life threatening.

No abstract

This study was designed to explore the value of markers of bone turnover, macrophage inflammatory protein-1a (MIP-1a), and osteopontin (OPN) in the diagnosis of myeloma bone disease. Twenty-five patients with newly diagnosed and untreated multiple myeloma (MM), and 22 age-, sex-, and bone mineral density-matched control subjects were enrolled. Levels of MIP-1a, OPN, carboxy-terminal telopeptide of Type-1 collagen (C-telopeptide or Ctx), deoxypyridinoline (DPD), Type-1 collagen propeptide (T1Pro), and bone-specific alkaline phosphatase (BALP) were assessed in both groups. Twenty-two of the patients had bone involvement documented by skeletal surveys and lumbar spinal magnetic resonance imaging. Levels of serum Ctx, OPN, MIP-1a, and urine DPD were significantly higher in MM patients with bone disease than in controls (P < 0.01). Serum Ctx levels were elevated in 90.9% of patients with MM and 40.9% of controls (P < 0.001). Urine DPD levels were elevated in 90.4% of the patients and 31.8% of the controls (P < 0.001). The serum OPN and MIP-1a levels of the patients were significantly correlated with b2-microglobulin and lactate dehydrogenase levels (P < 0.05). Our study indicates that Ctx and DPD are sensitive markers of bone disease in MM, and higher than normal values suggest presence of bone disease rather than benign osteoporosis in MM. The utility of OPN and MIP-1a needs to be further investigated. Am. J. Hematol. 82:185-191, 2007. V V C 2006 Wiley-Liss, Inc.

18587 Background: To determine the early and late arrhythmogenic effects of doxorubicin-containing chemotherapy regimens, and to identify associated risk. Methods: A prospective study including 29 patients who were treated with doxorubicin-containing regimens between September 2002 and September 2003. Cardiac evaluation was based on 24-hour electrocardiographic monitorization (Holter), which was performed during the first cycle of doxorubicin-containing regimens as well as after the last cycle of chemotherapy. Results: The mean age of the patients was 45.8 ± 15.1 (range 18–69) and the average dose of doxorubicin was 280.03 ± 113.50 mg/m2 (range 50–480). Holter records obtained during the first cycle of treatment revealed varying arrhythmias in 19 patients (65.5%). The most common arrhythmia was supraventricular extrasystole (n = 11, 37%). Holter records obtained after completion of therapy revealed a variety of rhythm abnormalities in 18 (62.1%) patients, with supraventricular extrasystole again being the most common arrhythmia (n = 13, 44.8%). Only 13 (44.8%) patients had arrhythmias documented in both Holter records. One patient presented with syncope during the first course of doxorubicin therapy and Mobitz type 2 atrioventricular block along with complete atrioventricular block lasting for 12 seconds were demonstrated after examination of Holter records. The patient subsequently underwent permanent pacemaker implantation. There was no correlation between the development of arrhythmia in the early and late period and sex, diagnosis, age, and previous radiotherapy history. Conclusion: Doxorubicin may result in arrhythmias both in early and late periods of treatment. These arrhythmias are rarely life threatening. No significant financial relationships to disclose.