The differential risk for cardiotoxicity between daunorubicin and doxorubicin has not been rigorously evaluated among childhood cancer survivors but based on hematologic toxicity has been assumed to be approximately equivalent. Here the authors report data from 7,387 survivors; 5,144 who received doxorubicin and 2,243 who received daunorubicin, with a median follow up of 17.3 years and a cumulative incidence of heart failure at age 40 years of 3.2 %. They found the average ratio of HRs for daunorubicin to doxorubicin to be 0.45 (95% CI, 0.23 to 0.73).
* Compared with doxorubicin, daunorubicin is less cardiotoxic among childhhod cancer survivors than most current guidelines suggest. This has implications for treatment protocols in terms of reducing cardiotoxicity as well as follow up guidelines