Coincident acute myelogenous leukemia and ischemic heart disease: use of the cardioprotectant dexrazoxane during induction chemotherapy.

Treatment of acute myelogenous leukemia is challenging in the setting of ischemic heart disease because anthracycline and anthracenedione drugs used in induction chemotherapy may potentiate myocardial dysfunction. We have managed two patients with coincident acute myelogenous leukemia and ischemic heart disease with the cardioprotectant drug dexrazoxane (ICRF-187), administered before each dose of mitoxantrone or idarubicin. Both patients tolerated their induction chemotherapy, developed marrow hypoplasia from chemotherapy, and achieved clinical remission. Dexrazoxane may have a role as a cardioprotectant in the treatment of select patients with acute myelogenous leukemia.