Dexrazoxane in Children With Cancer: From Evidence to Practice

See accompanying article doi:10.1200/JCO.2014.59.4473 Anthracyclines are used to treat different types of childhood cancer. Unfortunately, one of the most important adverse effects is cardiotoxicity, and the risk of developing cardiac disease is lifelong.1,2 The consequences of cardiac disease are extensive: it impairs the qual-ity of life3 and can cause premature death.4 Prevention of cardiac disease is thus very important. One of the most widely investigated possible cardioprotective agents is dexrazoxane.5 For years, there has been extensive interest in whether it can be used to prevent heart failure inchildrenwithcancer treatedwithanthracyclines, focusingon cardioprotection, antitumor efficacy (ie, survival and treatment re-sponse), and adverse effects such as secondarymalignant disease. The study by Chow et al6 adds important information to this discussion. The focus of their studywas on latemortality after dexrazoxane treat-ment in three Children’s Oncology Group randomized controlle