Female sex and higher drug dose as risk factors for late cardiotoxic effects of doxorubicin therapy for childhood cancer

The risk of heart abnormalities caused by doxorubicin in survivors of childhood cancer appears to be highest in females and patients who received higher cumulative doses of the drug. Researchers analyzed electrocardiograms of 62 females and 58 males who had received at least 244 milligrams of doxorubicin per square meter of body-surface area. The patients had been treated for acute lymphoblastic leukemia or osteogenic sarcoma, and their treatment had ended at least 2 years before evaluation. Female patients had weaker heart contractility and lower left ventricular mass than male patients. Patients who had received higher cumulative doses also had abnormal heart function. Longer time since treatment, younger age at diagnosis, and higher doxorubicin dose all increased the risk of thinning of the ventricular walls and reduced mass.