Continuous-Infusion Adriamycin

The use of adriamycin is frequently limited by the development of a cumulative-dose-dependent cardiomyopathy, which increases substantially in incidence at doses ≥550 mg/m2. To avoid the potential development of fatal refractory congestive heart failure (CHF), dose limitation to 450–550 mg/m2has been recommended by a variety of authors.1–3Since an oncologist may not wish to stop treatment of an individual patient at an arbitrary level, a considerable investment of time and resources has been made in an effort to extend the use of adriamycin or develop analogs with diminished cardiotoxicity to accomplish the same aim.