In 2015, there will be an estimated 11.3 million cancer survivors. With an increasing population of cancer survivors, it is imperative to understand the treatment options available and outcomes for chemotherapy-related cardiomyopathy. Anthracycline-based chemotherapy causes heart failure in approximately 5% of patients. Orthotopic heart transplantation (OHT) is an option for cancer survivors in complete remission who develop end-stage heart failure. We examined retrospective OHT data collected from the United Network of Organ Sharing from 1987 to 2011. The primary aim was to characterize the survival in patients with either the primary diagnosis of "dilated cardiomyopathy: Adriamycin" (DCA) versus "all other" causes of cardiomyopathy. The secondary aim was to define the differences in the primary cause of death and to describe the temporal relationship of DCA OHT. The United Network of Organ Sharing database identified 453 OHTs for the diagnosis of DCA and 51,312 OHTs for all other causes of cardiomyopathy. The DCA group was significantly younger with a greater percentage of women. After adjusting for age, gender, and history of malignancy, the 10-year survival curves showed that patients with DCA have an improved survival compared to those with all other causes of cardiomyopathy (hazard ratio 1.28, p = 0.026). No difference was found in the primary cause of death between the 2 groups. A statistically significant increasing temporal trend was seen in the number of OHTs for the diagnosis DCA. In conclusion, patients who undergo OHT for DCA have favorable 10-year survival, making OHT a good therapeutic option for end-stage heart failure due to anthracyclines. Additionally, no increased risk of cancer-related deaths was found in the DCA group, demonstrating that recurrent malignancy does not affect long-term survival. The temporal trends demonstrated that DCA remains a significant problem for cancer survivors.

译文

:2015年,估计将有1,130万癌症幸存者。随着癌症幸存者人数的增加,必须了解可用的治疗方案和化疗相关性心肌病的预后。基于蒽环类的化学疗法在大约5%的患者中引起心力衰竭。原位心脏移植(OHT)是完全缓解并发展为晚期心力衰竭的癌症幸存者的一种选择。我们检查了从1987年至2011年从器官共享联合网络收集的回顾性OHT数据。主要目的是鉴定患有“扩张型心肌病:阿霉素”(DCA)的主要诊断与“其他所有”原因的患者的生存特征。心肌病。第二个目的是确定主要死亡原因的差异,并描述DCA OHT的时间关系。器官共享网络联合会确定了用于诊断DCA的453个OHT,以及所有其他引起心肌病的原因的51,312个OHT。 DCA组明显年轻,女性比例更高。在对年龄,性别和恶性肿瘤病史进行调整后,10年生存曲线显示DCA患者的生存率比所有其他原因的心肌病患者高(危险比1.28,p = 0.026)。两组之间的主要死亡原因均未发现差异。诊断DCA的OHT数量出现了统计上显着增加的时间趋势。总之,接受OHT进行DCA治疗的患者具有良好的10年生存期,这使OHT成为治疗因蒽环类药物所致晚期心力衰竭的良好治疗选择。此外,在DCA组中未发现与癌症相关的死亡风险增加,表明复发性恶性肿瘤不会影响长期生存。时间趋势表明,DCA对于癌症幸存者仍然是一个重大问题。

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