[CHF arising after low dose THP-COP chemotherapy in an elderly patient with malignant lymphoma].

Abstract

A 76-year-old woman was admitted with a one-month history of low grade fever and dizziness. She had a palpable right supraclavicular lymph node. Abdominal ultrasonography showed swollen lymph nodes around the abdominal aorta. A specimen from the right supraclavicular lymph node showed malignant lymphoma (diffuse large B cell type). We started chemotherapy according to the low-dose THP-COP protocol (pirarubicin, cyclophosphamide, vincristine and prednisolone) on the 31st hospital day. Since no adverse effects were detected after two low-dose cycles, the patient received a third course with standard doses on the 87th hospital day. The total dose of pirarubicin was 72 mg/m2. Two days after the third course started, she suffered from dyspnea caused by congestive heart failure. A chest X-ray showed advanced cardiomegaly, severe congestion and bilateral pleural effusion. These conditions improved with transvenous administration of diuretics, a vasodilator and phosphodiesterase inhibitor. In this case, congestive heart failure developed even though the total dose of pirarubicin was lower than in previous reports of this complication. When the THP-COP protocol is indicated in elderly patients, cardiotoxicity should be monitored even if the total dose of pirarubicin is very low.

• Authors: K Matoba-Ueno, S Fujimoto, N Doi, T Nishino, S Yamano, H Shiiki, T Hashimoto, S Nakamura
• Journal: Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics (Nihon Ronen Igakkai Zasshi) Vol. 38 Issue 4 Pg. 548-53 (Jul 2001) ISSN: 0300-9173 [Print] Japan
• PMID: 11523171 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Antibiotics, Antineoplastic
• Vincristine
• Doxorubicin
• Cyclophosphamide
• Prednisolone
• pirarubicin

Topics

• Aged
• Antibiotics, Antineoplastic (adverse effects)
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects, therapeutic use)
• Cyclophosphamide (administration & dosage)
• Doxorubicin (administration & dosage, adverse effects, analogs & derivatives)
• Female
• Heart Failure (chemically induced)
• Humans
• Lymphoma, B-Cell (drug therapy)
• Lymphoma, Large B-Cell, Diffuse (drug therapy)
• Prednisolone (administration & dosage)
• Vincristine (administration & dosage)