Cardiac toxicity following high-dose cyclophosphamide, cisplatin, and BCNU (STAMP-I) for breast cancer

• Published in: Biology of blood and marrow transplantation 2000-01, Vol.6 (2), p.198-203
• Main Authors: Nieto, Yago, Cagnoni, Pablo J., Bearman, Scott I., Shpall, Elizabeth J., Matthes, Steve, Jones, Roy B.
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - toxicity; Area Under Curve; Arrhythmias, Cardiac - chemically induced; Arrhythmias, Cardiac - etiology; Breast Neoplasms - complications; Breast Neoplasms - drug therapy; Cardiomyopathies - chemically induced; Cardiomyopathies - etiology; Carmustine - administration & dosage; Carmustine - toxicity; Cisplatin - administration & dosage; Cisplatin - toxicity; Cyclophosphamide - administration & dosage; Cyclophosphamide - toxicity; Female; Hematopoietic Stem Cell Transplantation; Humans; Middle Aged; Retrospective Studies; Risk Factors; Stroke Volume; Transplantation, Autologous; X-Ray Therapy - adverse effects
• ISSN: 1083-8791; 1523-6536
• DOI: 10.1016/S1083-8791(00)70043-7

We retrospectively evaluated 443 breast cancer patients treated with high-dose cyclophosphamide, cisplatin, and BCNU (STAMP-I) with autologous stem cell support to characterize the cardiac toxicity of this regimen. Patients had stage II-III (n = 243) or stage IV (n = 200) breast cancer. We observed an overall 5.1% incidence of cardiac complications, both clinical and subclinical, in the whole group: 4.9% in stage II-III and 5.5% in stage IV patients. Clinical cardiomyopathy (CMP) was observed in 1.6% of stage II-III patients (1 case of fatal grade 5 toxicity and 3 cases of grade 3 CMP) and in 3.5% of patients with stage IV disease (1 case of grade 4 and 6 cases of grade 3). The incidence of cardiac toxicity did not differ significantly between the groups. Prior radiation therapy to the mediastinum or left chest wall (P = .001) and advanced age (P = .01) were independent predictors of an increased risk of the appearance of this complication. No pharmacodynamic correlation was observed between any of the 3 drugs and cardiac toxicity. Biol Blood Marrow Transplant 2000;6(2A):198-203.