A 45-year-old woman who completed anthracycline-based chemotherapy for breast cancer eight years ago presents with progressive dyspnea. Echo shows a dilated left ventricle with an EF of 35%. Her cardiomyopathy is attributed to doxorubicin. Which agent is given before anthracycline administration to reduce this risk?

• A Leucovorin
• B Mesna
• C Amifostine
• D Dexrazoxane ✓

Explanation

Doxorubicin generates free radicals through iron-catalysed reactions and causes cumulative, dose-dependent cardiomyopathy that is usually irreversible. Dexrazoxane is an iron chelator given before each anthracycline dose; it limits intramyocardial iron-dependent radical formation and significantly lowers the incidence of cardiomyopathy. Mesna protects against cyclophosphamide hemorrhagic cystitis, amifostine against cisplatin nephrotoxicity, and leucovorin rescues cells from methotrexate toxicity.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.