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Successful recovery and allogeneic stem cell transplant following chemotherapy-induced severe cardiomyopathy: literature review of management and prognostic factors
  1. Muhammad Asim Shahzad1,
  2. Rizwan Ishtiaq1,
  3. Umar Zahid1,
  4. Faiz Anwer2
  1. 1Department of General Internal Medicine, University of Arizona Medical Center—University Campus, Tucson, Arizona, USA
  2. 2Department of Hematology Oncology, University of Arizona Medical Center, Tucson, Arizona, USA
  1. Correspondence to Dr Faiz Anwer, anwerf{at}


Chemotherapy-induced cardiomyopathy is one of the major possible hazards that can result from potential cardiotoxic agents while treating cancer. Prognostic risk factors include the rate of drug administration, history of hypertension, female gender, extremes of age, previous history of mediastinal irradiation, cumulative dose and pre-existing heart disease. Close monitoring of the patients, timely diagnosis, use of well-known biomarkers including cardiac troponins, NT-ProBNP and imaging studies like 2D Echo or cardiac MRI are essential. Emerging biomarkers include carbonyl reductases (CBR1 and CBR3), aldo-keto reductases (AKR, type 1A1, 1C3, 7A2) and topoisomerase2β (Top2β). β blockers and ACE inhibitors have not only been shown to slow down the progression of cardiac dysfunction but also produce symptomatic improvement. Our case report describes a patient with acute myeloblastic leukaemia who developed severe cardiomyopathy acutely after starting the anthracycline-based regimen. Nevertheless, with timely intervention her symptoms improved and subsequently she successfully received allogeneic stem cell transplantation.

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  • MAS and RI equally contributed as first co-authors.

  • Contributors MAS, RI, UZ and FA designed the study and searched the published literature for the review. All authors performed the study, contributed to data extraction, analyzed the data and wrote the paper.

  • Funding The study was supported by National Cancer Institute (P30 CA023074).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.