Cyclophosphamide and ifosfamide high-dose therapy may cause severe cardiomyopathy and heart failure in patients undergoing stem cell transplantation. Acute myocyte necrosis, with damage to the endothelial lining of the heart, and hemorrhagic myopericarditis may occur with a 30% mortality rate. The ECG shows abnormal patterns and the chest x-ray is a good test for detecting heart failure. An echocardiogram is not a test used for the detection of heart failure, but it is useful in revealing weakness of the heart muscle, pericarditis, or pericardial effusions. Serious complications are more common in patients with pre¬existing heart disease, particularly in those with left ventricular dysfunction and an ejection fraction of less than 45%.
Interferon alfa is a drug used in the management of chronic myelogenous leukemia, hairy cell leukemia, and Kaposi’s sarcoma. It may cause severe dilated cardiomyo-pathy with symptoms and signs of heart failure that are reversible when the drug is discontinued.
Interleukin-2 is a drug that has been noted to cause hypotension, rarely myocardial infarction, noncardiogenic pulmonary edema, and kidney failure.