Acute Cardiotoxicity After Daunorubicin in Acute Myeloid Leukaemia

Use of the anthracycline antibiotics daunorubicin and adriamycin as antineoplastic agents is limited by dose-dependent, late cardiac toxicity. We describe a patient who developed fatal cardiogenic shock after comparatively low dose daunorubicin early in the treatment of acute myeloid leukaemia (A.M.L.). She was young with no previous cardiac history: investigations for an infectious aetiology were negative and at post-mortem there was no evidence of leukaemic infiltration. This unusual case demonstrates that standard doses of daunorubicin in A.M.L. may be followed early in the treatment by severe cardiac damage.