Doxorubicin (adriamycin) cardiomyopathy.

Despite its vast utility in clinical oncology, the use of doxorubicin hydrochloride (Adriamycin) is limited by a potentially fatal cardiomyopathy. The following critical review, which examines the natural course, histopathologic effects, risk factors and monitoring indicators of this toxicity, also analyzes recent research of proposed mechanisms, including free radical formation with depletion of detoxifying enzymes, inhibition of vital enzyme systems and alterations in relative calcium concentrations. Prevention of the adverse reaction has been attempted by using such agents as alpha-tocopherol, selenium sulfide, coenzyme Q(10), sulfhydryl donors, nucleosides and razoxane, and via liposomal carriage and alternative methods of administration.