Sudden death of a patient in complete remission after anthracycline therapy for acute lymphoblastic leukemia

Tsuda, Naoya; Oka, Ryuji; Kajino, Hiroki; Kajino, Mayumi; Okuno, Akimasa

doi:10.1046/j.1442-200x.2000.01212.x

Cited by 5 publications

(2 citation statements)

References 9 publications

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“…It is becoming recognized that acute cardiac death may be a late complication of chemotherapy, for example following anthracycline [234,235]. Late death can also occur from surgically corrected congenital heart disease [236][237][238][239].…”

Section: Sudden Cardiac Death: Other Aetiologiesmentioning

confidence: 99%

Sudden adult death

Langlois

2009

Forensic Sci Med Pathol

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In the investigation of sudden death in adults, channelopathies, such as long QT syndrome, have risen to the fore in the minds of forensic pathologists in recent years. Examples of these disorders are touched upon in this review as an absence of abnormal findings at postmortem examination is characteristic and the importance of considering the diagnosis lies in the heritable nature of these conditions. Typically, a diagnosis of a possible channelopathy is evoked as an explanation for a 'negative autopsy' in a case of apparent sudden natural death. However, the one potential adverse effect of this approach is that subtle causes of sudden death may be overlooked. The intention of this article is to review and discuss potential causes of sudden adult death (mostly natural) that should be considered before resorting to a diagnosis of possible channelopathy. Nonetheless, it becomes apparent that many of the potential causes of sudden death can have a genetic basis. Thus, it becomes an important consideration that there may be a genetic basis to sudden death that extends beyond the negative autopsy.

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Section: Sudden Cardiac Death: Other Aetiologiesmentioning

confidence: 99%

Sudden adult death

Langlois

2009

Forensic Sci Med Pathol

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“…The BB bisoprolol, the ACEI perindopril, and the AA eplerenone were previously proven to decrease the risk of hospitalisation and death in clinical studies [60][61][62]. As DOX cardiotoxicity also contributes to a higher hospitalisation rate, decreased quality of life, and lower survival rate [3,[63][64][65], the administration of these agents certainly leads to better clinical outcomes, once manifest HF has been detected in the oncological patient. Lately, we have shown that the prophylactic combination of these 3 drugs effectively decreases mortality and prevents myocardial deterioration in a translational rat model [40].…”

Section: Discussionmentioning

confidence: 99%

Prophylactic, single-drug cardioprotection in a comparative, experimental study of doxorubicin-induced cardiomyopathy

et al. 2020

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Background Cardiomyopathy is a common side effect of doxorubicin (DOX) chemotherapy. Despite intensive research efforts in the field, there is still no evidence available for routine cardioprotective prophylaxis to prevent cardiotoxicity in the majority of oncological patients at low risk of cardiovascular disease. We have recently demonstrated the advantages of a prophylactic, combined heart failure therapy in an experimental model of DOX-induced cardiomyopathy. In the current work, we focus on individually applied prophylactic medications studied in the same translational environment to clarify their distinct roles in the prevention of DOX cardiotoxicity. Methods Twelve-week-old male Wistar rats were divided into 5 subgroups. Prophylactic β-blocker (BB, bisoprolol), angiotensin-converting enzyme inhibitor (ACEI, perindopril) or aldosterone antagonist (AA, eplerenone) treatments were applied 1 week before DOX administration, then 6 cycles of intravenous DOX chemotherapy were administered. Rats receiving only intravenous DOX or saline served as positive and negative controls. Blood pressure, heart rate, body weight, and echocardiographic parameters were monitored in vivo. Two months after the last DOX administration, the animals were sacrificed, and their heart and serum samples were frozen in liquid nitrogen for histological, mechanical, and biochemical measurements. Results All prophylactic treatments increased the survival of DOX-receiving animals. The lowest mortality rates were seen in the BB and ACEI groups. The left ventricular ejection fraction was only preserved in the BB group. The DOX-induced increase in the isovolumetric relaxation time could not be prevented by any prophylactic treatment. A decreased number of apoptotic nuclei and a preserved myocardial ultrastructure were found in all groups receiving prophylactic cardioprotection, while the DOX-induced fibrotic remodelling and the increase in caspase-3 levels could only be substantially prevented by the BB and ACEI treatments. Conclusion Primary prophylaxis with cardioprotective agents like BB or ACEI has a key role in the prevention of DOX-induced cardiotoxicity in healthy rats. Future human studies are necessary to implement this finding in the clinical management of oncological patients free of cardiovascular risk factors.

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Natural Causes of Sudden Death: Noncardiac

Fineschi

Turillazzi

2009

Wiley Encyclopedia of Forensic Science

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Sudden death is a devastating complication of many underlying disorders. Although cardiovascular disease accounts for most of these episodes of sudden natural death, many other causes contribute. Every organ system may be responsible for sudden death. Respiratory causes are considered focusing on the major causes such as pneumonia and pulmonary embolism. Rare but potentially fatal events, such as amniotic fluid embolism and fat embolism, are stressed too. Sudden deaths from hematological disorders include both hemoglobinopathies and leukemia. Sometimes no satisfactory cause of death could be found from the necropsy; the review of the medical history became of paramount importance. We refer to sudden and unexplained deaths in young patients with Type 1 DM. There is growing evidence of the so‐called dead‐in‐bed syndrome with diabetes. Other rare metabolic disorders, such as alcoholic ketoacidosis, hypoglycemia, thyroiditis are discussed. Sudden deaths also occurred in patients with a history of anaphylaxis in whom no satisfactory cause of death was found after extensive necropsy and toxicological examination. In these cases, no specific macroscopic or microscopic findings are detected at autopsy; so in the presence of a clinical history suggestive for anaphylaxis‐related death, postmortem measurement of serum tryptase levels can be a useful diagnostic aid. The role of massive adrenal hemorrhage (Waterhouse‐Friderichsen syndrome) in causing sudden death is also discussed.

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Sudden death of a patient in complete remission after anthracycline therapy for acute lymphoblastic leukemia

Cited by 5 publications

References 9 publications

Sudden adult death

Sudden adult death

Prophylactic, single-drug cardioprotection in a comparative, experimental study of doxorubicin-induced cardiomyopathy

Natural Causes of Sudden Death: Noncardiac

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