Trial reportPediatrics2012
Continuous Versus Bolus Infusion of Doxorubicin in Children With ALL: Long-term Cardiac Outcomes.
Trial report in Pediatrics, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
62 citing papers in PubMed, 1 synthesis or guideline pooled it, 174 citations in OpenAlex.
- Different dosage schedules for reducing cardiotoxicity in people with cancer receiving anthracycline chemotherapy.The Cochrane database of systematic reviews · 2016Pooled it
- Cardiovascular and Oncologic Considerations in Adult Hodgkin Lymphoma: JACC: CardioOncology State-of the-Art Review.JACC. CardioOncology · 2025Review
- Emerging Strategies for the Prevention of Chemotherapy-Induced Cardiotoxicity in Paediatric Cancer Patients: Advances and Future Perspectives.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Cardiovascular Toxicity in Patients Treated for Childhood Cancer: A Scientific Statement From the American Heart Association.Circulation · 2025Review
- Treatment of T-cell Leukemia/Lymphoma in Children and Young Adults With the Memorial Sloan Kettering Cancer Center New York IIB Protocol.Journal of pediatric hematology/oncology · 2025Article
- Pediatric Cardio-Oncology: Screening, Risk Stratification, and Prevention of Cardiotoxicity Associated with Anthracyclines.Children (Basel, Switzerland) · 2024Review
- Comparison of bolus administration and short-term infusion versus long-term infusion of doxorubicin in terms of cardiotoxicity and efficacy.Naunyn-Schmiedeberg's archives of pharmacology · 2024Review
- Doxorubicin concentrations in bone tumour-relevant tissues after bolus and continuous infusion: a randomized porcine microdialysis study.Cancer chemotherapy and pharmacology · 2024Article
- Doxorubicin-Induced Cardiomyopathy: A Preliminary Study on the Cardioprotective Benefits of 7-Hydroxyflavanone.International journal of molecular sciences · 2023Article
- Altered Peripheral Blood Gene Expression in Childhood Cancer Survivors With Anthracycline-Induced Cardiomyopathy - A COG-ALTE03N1 Report.Journal of the American Heart Association · 2023Article
- Electrocardiographic and biochemical analysis of anthracycline induced cardiotoxicity in breast cancer patients from Southern Sri Lanka.BMC cancer · 2023Article
- Diagnosis and Management of Cancer Treatment-Related Cardiac Dysfunction and Heart Failure in Children.Children (Basel, Switzerland) · 2023Review
- Early Doxorubicin Myocardial Injury: Inflammatory, Oxidative Stress, and Apoptotic Role of Galectin-3.International journal of molecular sciences · 2022Article
- Cardioprotection of High-Risk Individuals.Heart failure clinics · 2022Review
- Mitochondrial-Targeted Therapy for Doxorubicin-Induced Cardiotoxicity.International journal of molecular sciences · 2022Review
- Divergent Cardiac Effects of Angiotensin II and Isoproterenol Following Juvenile Exposure to Doxorubicin.Frontiers in cardiovascular medicine · 2022Article
- Juvenile exposure to doxorubicin alters the cardiovascular response to adult-onset psychosocial stress in mice.Stress (Amsterdam, Netherlands) · 2022Article
- Cancer and cardiovascular disease: can understanding the mechanisms of cardiovascular injury guide us to optimise care in cancer survivors?Ecancermedicalscience · 2022Review
- Prevention of Anthracycline-Induced Cardiotoxicity: The Good and Bad of Current and Alternative Therapies.Frontiers in cardiovascular medicine · 2022Review
- Novel Therapeutics for Anthracycline Induced Cardiotoxicity.Frontiers in cardiovascular medicine · 2022Review
2 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
20 authors at 11 institutions in 2 countries.
Funding
Abstract
BACKGROUND AND
objectivesDoxorubicin, effective against many malignancies, is limited by cardiotoxicity. Continuous-infusion doxorubicin, compared with bolus-infusion, reduces early cardiotoxicity in adults. Its effectiveness in reducing late cardiotoxicity in children remains uncertain. We determined continuous-infusion doxorubicin cardioprotective efficacy in long-term survivors of childhood acute lymphoblastic leukemia (ALL).
methodsThe Dana-Farber Cancer Institute ALL Consortium Protocol 91-01 enrolled pediatric patients between 1991 and 1995. Newly diagnosed high-risk patients were randomly assigned to receive a total of 360 mg/m(2) of doxorubicin in 30 mg/m(2) doses every 3 weeks, by either continuous (over 48 hours) or bolus-infusion (within 15 minutes). Echocardiograms at baseline, during, and after doxorubicin therapy were blindly remeasured centrally. Primary outcomes were late left ventricular (LV) structure and function.
resultsA total of 102 children were randomized to each treatment group. We analyzed 484 serial echocardiograms from 92 patients (n = 49 continuous; n = 43 bolus) with ≥1 echocardiogram ≥3 years after assignment. Both groups had similar demographics and normal baseline LV characteristics. Cardiac follow-up after randomization (median, 8 years) showed changes from baseline within the randomized groups (depressed systolic function, systolic dilation, reduced wall thickness, and reduced mass) at 3, 6, and 8 years; there were no statistically significant differences between randomized groups. Ten-year ALL event-free survival rates did not differ between the 2 groups (continuous-infusion, 83% versus bolus-infusion, 78%; P = .24).
conclusionsIn survivors of childhood high-risk ALL, continuous-infusion doxorubicin, compared with bolus-infusion, provided no long-term cardioprotection or improvement in ALL event-free survival, hence provided no benefit over bolus-infusion.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.