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Costly cancer treatment aimed at protecting kids hearts offers no additional benefit

A new study refutes a long-held but unproven theory that children suffering from acute lymphoblastic leukemia might suffer less heart damage if treated with longer-lasting infusions of chemotherapy.

Each of these longer-lasting treatments requires a child to spend at least two days in the hospital, causing tremendous anxiety and inconvenience, and costing millions of dollars in the U.S. each year. Details of the study by physicians at 10 hospitals throughout the United States and Canada will be published in the March 15 issue of the Journal of Clinical Oncology.

On average, 7,000 U.S. children are diagnosed with cancer each year. For the thousands who receive chemotherapy, one of the possible side effects is heart damage. For years, physicians believed that giving children who have acute lymphoblastic leukemia - the most common type of cancer in young children - a lower peak dose of the widely used chemotherapy drug doxorubicin might prevent cardiomyopathy, a weakening of the heart muscle often caused by the treatment.

There was little data, however, to back up this claim. Prior studies examining the protective effects of continuous doxorubicin in adults didnt provide long-term heart data.

In theory, using this treatment method for children sounded great, says the studys lead author, Steven Lipshultz, M.D., chief of pediatric cardiology at the University of Rochester Medical Centers Strong Childrens Hospital and a professor of oncology at the Universitys James P. Wilmot Cancer Center. Its been written into national and international treatment protocols to protect the heart.

The study involved 240 children who had high-risk, acute lymphoblastic leukemia. Physicians compared cardiac outcomes of children receiving bolus treatments - a injection of doxorubin done within one hour - to those who received the medication by continuous infusion during a 48-hour span, which Lipshultz describes as a trickle at a time. Physicians obtai
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Contact: Travis Anderson
travis_anderson@urmc.rochester.edu
585-273-1757
University of Rochester Medical Center
14-Mar-2002


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