Fatal congestive heart failure following mitoxantrone treatment in two children previously treated with doxorubicin and cisplatin.

Two children, who had received chemotherapy with doxorubicin and cisplatin for disseminated chondrosarcoma and recurrent rhabdomyosarcoma, developed congestive heart failure following treatment with mitoxantrone (DHAD); the total doses of DHAD were 128 and 90 mg/m2, respectively. The patient with chondrosarcoma had relief of his cardiac symptoms with digitalis and furosemide. The patient with rhabdomyosarcoma, whose tumor responded following treatment with DHAD, died 2 weeks after development of congestive heart failure. For patients who have received prior treatment with potentially cardiotoxic agents, administration of DHAD should be followed by careful monitoring of cardiac function.