Cardiac abnormalities after AMSA administration
AMSA produced changes on echocardiograms of 18 of 27 patients. Seven patients developed clinical congestive heart failure. The occurrence of cardiac abnormalities was influenced by the previous anthracycline dose and the rate and dose of AMSA administered. No changes were seen in six patients, with a total anthracycline dose less than or equal to 400 mg/m2 and less than 200 mg/m2 of AMSA given on 2 consecutive days. Seven of eight patients had abnormalities with an anthracycline dose less than or equal to 400 mg/m2 but greater than or equal to 200 mg/m2 of AMSA in 48 hours. Nine of 11 patients had abnormalities when AMSA was given after a total anthracycline dose of 400 mg/m2. When the total combined anthracycline and AMSA dose was greater than or equal to 900 mg/m2, 13 of 14 patients had abnormalities while only three of 11 who received less than this dose had abnormalities. The abnormalities may be reversible with prompt treatment and discontinuation of drug.