Cyclophosphamide-induced cardiotoxicity with a prolonged clinical course diagnosed on an endomyocardial biopsy.

Abstract

A 31-year-old woman with primary mediastinal large B-cell lymphoma refractory to conventional chemotherapy was treated with high-dose chemotherapy containing cyclophosphamide (CY). Subsequently, she was treated with auto peripheral blood stem cell transplantation. Although a complete remission was obtained, heart failure developed two months later. Echocardiography showed an impaired systolic function with pericardial effusion. A biopsy of the endomyocardial region from the left ventricle demonstrated spotty myocardial hemorrhage and myocardial fibrosis with disruption and aggregation of mitochondrial cristae. Based on these findings, CY-induced cardiotoxicity was diagnosed. The patient was treated with conventional therapy for heart failure, which required approximately one year to improve her condition.

• Authors: Saburo Kusumoto, Hiroaki Kawano, Tomayoshi Hayashi, Osami Satoh, Tsuyoshi Yonekura, Masamichi Eguchi, Masayoshi Takeno, Akira Tsuneto, Yuji Koide, Tatsuro Jo, Koji Maemura
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 52 Issue 20 Pg. 2311-5 ( 2013) ISSN: 1349-7235 [Electronic] Japan
• PMID: 24126391 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antineoplastic Agents, Alkylating
• Cardiotoxins
• Cyclophosphamide

Topics

• Adult
• Antineoplastic Agents, Alkylating (adverse effects)
• Biopsy
• Cardiotoxins (adverse effects)
• Cyclophosphamide (adverse effects)
• Female
• Heart Failure (chemically induced, diagnosis)
• Humans
• Myocardium (pathology)
• Time Factors