{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:37:14Z","timestamp":1790800634300,"version":"4.1.0"},"reference-count":25,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"24","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2015,8,20]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> Given concerns that dexrazoxane may reduce treatment efficacy, induce second cancers, and thus compromise overall survival among children, we examined long-term overall and cause-specific mortality and disease relapse rates from three randomized clinical trials. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> Children's Oncology Group trials P9404 (T-cell acute lymphoblastic leukemia\/lymphoma; n = 537), P9425 (intermediate\/high-risk Hodgkin lymphoma; n = 216), and P9426 (low-risk Hodgkin lymphoma; n = 255) were conducted between 1996 and 2001. Each trial randomly assigned patients to doxorubicin with or without dexrazoxane. The dexrazoxane:doxorubicin dose ratio was 10:1, and the cumulative protocol-specified doxorubicin dose was 100 to 360 mg\/m<jats:sup>2<\/jats:sup>. Dexrazoxane was given as an intravenous bolus before each doxorubicin dose. Data from all three trials were linked with the National Death Index to determine overall and cause-specific mortality by dexrazoxane status. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Among 1,008 patients (507 received dexrazoxane) with a median follow-up of 12.6 years (range, 0 to 15.5 years), 132 died (67 received dexrazoxane). Overall mortality did not vary by dexrazoxane status (12.8% with dexrazoxane at 10 years v 12.2% without; hazard ratio [HR], 1.03; 95% CI, 0.73 to 1.45). Findings were similar when each trial was examined separately. Dexrazoxane also was not significantly associated with differential causes of death. The original cancer caused 76.5% of all deaths (HR, 0.90; 95% CI, 0.61 to 1.32) followed by second cancers (13.6% of deaths; HR, 1.24; 95% CI, 0.49 to 3.15). Specifically, dexrazoxane was not associated with deaths from acute myeloid leukemia\/myelodysplasia or cardiovascular events. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Among pediatric patients with leukemia or lymphoma, after extended follow-up, dexrazoxane use did not seem to compromise long-term survival. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2014.59.4473","type":"journal-article","created":{"date-parts":[[2015,5,27]],"date-time":"2015-05-27T14:36:58Z","timestamp":1432737418000},"page":"2639-2645","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":89,"title":["Late Mortality After Dexrazoxane Treatment: A Report From the Children's Oncology Group"],"prefix":"10.1200","volume":"33","author":[{"given":"Eric J.","family":"Chow","sequence":"first","affiliation":[{"name":"Eric J. Chow, David R. Doody, Wendy M. Leisenring, and K. Scott Baker, Fred Hutchinson Cancer Research Center, Seattle Children's Hospital, University of Washington, Seattle, WA; Barbara L. Asselin and Louis S. Constine, University of Rochester Medical Center and School of Medicine, Rochester, NY; Cindy L. Schwartz, University of Texas MD Anderson Cancer Center, Houston, TX; Sanjeev Aggarwal and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University, Detroit, MI; Smita Bhatia,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara L.","family":"Asselin","sequence":"additional","affiliation":[{"name":"Eric J. Chow, David R. Doody, Wendy M. Leisenring, and K. Scott Baker, Fred Hutchinson Cancer Research Center, Seattle Children's Hospital, University of Washington, Seattle, WA; Barbara L. Asselin and Louis S. Constine, University of Rochester Medical Center and School of Medicine, Rochester, NY; Cindy L. Schwartz, University of Texas MD Anderson Cancer Center, Houston, TX; Sanjeev Aggarwal and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University, Detroit, MI; Smita Bhatia,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy L.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Eric J. Chow, David R. Doody, Wendy M. Leisenring, and K. Scott Baker, Fred Hutchinson Cancer Research Center, Seattle Children's Hospital, University of Washington, Seattle, WA; Barbara L. Asselin and Louis S. Constine, University of Rochester Medical Center and School of Medicine, Rochester, NY; Cindy L. Schwartz, University of Texas MD Anderson Cancer Center, Houston, TX; Sanjeev Aggarwal and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University, Detroit, MI; Smita Bhatia,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Doody","sequence":"additional","affiliation":[{"name":"Eric J. Chow, David R. Doody, Wendy M. Leisenring, and K. Scott Baker, Fred Hutchinson Cancer Research Center, Seattle Children's Hospital, University of Washington, Seattle, WA; Barbara L. Asselin and Louis S. Constine, University of Rochester Medical Center and School of Medicine, Rochester, NY; Cindy L. Schwartz, University of Texas MD Anderson Cancer Center, Houston, TX; Sanjeev Aggarwal and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University, Detroit, MI; Smita Bhatia,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy M.","family":"Leisenring","sequence":"additional","affiliation":[{"name":"Eric J. Chow, David R. Doody, Wendy M. Leisenring, and K. Scott Baker, Fred Hutchinson Cancer Research Center, Seattle Children's Hospital, University of Washington, Seattle, WA; Barbara L. Asselin and Louis S. Constine, University of Rochester Medical Center and School of Medicine, Rochester, NY; Cindy L. Schwartz, University of Texas MD Anderson Cancer Center, Houston, TX; Sanjeev Aggarwal and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University, Detroit, MI; Smita Bhatia,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeev","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Eric J. Chow, David R. Doody, Wendy M. Leisenring, and K. Scott Baker, Fred Hutchinson Cancer Research Center, Seattle Children's Hospital, University of Washington, Seattle, WA; Barbara L. Asselin and Louis S. Constine, University of Rochester Medical Center and School of Medicine, Rochester, NY; Cindy L. Schwartz, University of Texas MD Anderson Cancer Center, Houston, TX; Sanjeev Aggarwal and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University, Detroit, MI; Smita Bhatia,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. Scott","family":"Baker","sequence":"additional","affiliation":[{"name":"Eric J. Chow, David R. Doody, Wendy M. Leisenring, and K. Scott Baker, Fred Hutchinson Cancer Research Center, Seattle Children's Hospital, University of Washington, Seattle, WA; Barbara L. Asselin and Louis S. Constine, University of Rochester Medical Center and School of Medicine, Rochester, NY; Cindy L. Schwartz, University of Texas MD Anderson Cancer Center, Houston, TX; Sanjeev Aggarwal and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University, Detroit, MI; Smita Bhatia,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smita","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Eric J. Chow, David R. Doody, Wendy M. Leisenring, and K. Scott Baker, Fred Hutchinson Cancer Research Center, Seattle Children's Hospital, University of Washington, Seattle, WA; Barbara L. Asselin and Louis S. Constine, University of Rochester Medical Center and School of Medicine, Rochester, NY; Cindy L. Schwartz, University of Texas MD Anderson Cancer Center, Houston, TX; Sanjeev Aggarwal and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University, Detroit, MI; Smita Bhatia,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis S.","family":"Constine","sequence":"additional","affiliation":[{"name":"Eric J. Chow, David R. Doody, Wendy M. Leisenring, and K. Scott Baker, Fred Hutchinson Cancer Research Center, Seattle Children's Hospital, University of Washington, Seattle, WA; Barbara L. Asselin and Louis S. Constine, University of Rochester Medical Center and School of Medicine, Rochester, NY; Cindy L. Schwartz, University of Texas MD Anderson Cancer Center, Houston, TX; Sanjeev Aggarwal and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University, Detroit, MI; Smita Bhatia,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Freyer","sequence":"additional","affiliation":[{"name":"Eric J. Chow, David R. Doody, Wendy M. Leisenring, and K. Scott Baker, Fred Hutchinson Cancer Research Center, Seattle Children's Hospital, University of Washington, Seattle, WA; Barbara L. Asselin and Louis S. Constine, University of Rochester Medical Center and School of Medicine, Rochester, NY; Cindy L. Schwartz, University of Texas MD Anderson Cancer Center, Houston, TX; Sanjeev Aggarwal and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University, Detroit, MI; Smita Bhatia,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven E.","family":"Lipshultz","sequence":"additional","affiliation":[{"name":"Eric J. Chow, David R. Doody, Wendy M. Leisenring, and K. Scott Baker, Fred Hutchinson Cancer Research Center, Seattle Children's Hospital, University of Washington, Seattle, WA; Barbara L. Asselin and Louis S. Constine, University of Rochester Medical Center and School of Medicine, Rochester, NY; Cindy L. 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