Table 3. Cardiomyopathy HRs and Mean Equivalence Ratios for Various Anthracyclines or Mitoxantrone Relative to Doxorubicin.
| Exposure | Participants, No. | HR (95% CI)a | Ratio (95% CI) | ||||
|---|---|---|---|---|---|---|---|
| Clinical Cardiomyopathy | Dose Information | <150 mg/m2 | 150-299 mg/m2 | ≥300 mg/m2 | Mean | Linear Dose-Response Model | |
| Daunorubicin | 65 | 4328 | 1.4 (0.9-2.1) | 2.8 (1.7-4.5) | 6.0 (3.8-9.3) | ||
| Doxorubicin | 1.8 (1.2-2.6) | 4.6 (3.3-6.4) | 12.6 (9.8-16.3) | ||||
| Daunorubicin to doxorubicin ratio | 0.8 | 0.6 | 0.5 | 0.6 (0.4-1.0) | 0.5 (0.4-0.7) | ||
| Epirubicin | 9 | 342 | 1.9 (0.3-13.7) | 2.4 (0.6-9.9) | 6.0 (2.6-13.9) | ||
| Doxorubicin | 1.5 (0.99-2.2) | 4.2 (3.1-5.7) | 11.3 (8.8-14.4) | ||||
| Epirubicin to doxorubicin ratio | 1.3 | 0.6 | 0.5 | 0.8 (0.5-2.8) | 0.8 (0.3-1.4) | ||
| Idarubicinb | 5 | 238 | 0 | 3.8 (1.5-9.5) | 0 | ||
| Doxorubicin | 1.4 (0.9-2.1) | 4.1 (3.0-5.7) | 11.1 (8.6-14.1) | ||||
| Idarubicin to doxorubicin ratio | 0 | 0.9 | 0 | NE | NE | ||
| Mitoxantronec | 19 | 261 | 4.2 (1.8-9.9) | 4.2 (1.6-11.4) | 48.3 (24.2-96.5) | ||
| Doxorubicin | 1.5 (1.0-2.3) | 4.4 (3.2-6.0) | 11.6 (9.1-15.0) | ||||
| Mitoxantrone to doxorubicin ratio | 2.8 | 1.0 | 4.2 | 10.5 (6.2-19.1)d | 13.8 (8.0-21.6)d | ||
Abbreviations: HRs, hazard ratios; NE, not estimable.
a
Patient without exposure to the given anthracycline or anthraquinone as referent; models were adjusted for sex, age at diagnosis, exposure to any other anthracycline or mitoxantrone besides the 2 being compared, and stratified by cohort.
b
Idarubicin doses multiplied by a factor of 5 to facilitate comparability to doxorubicin doses; at a level of less than 150 mg/m2, 82 patients had dose information (none with cardiomyopathy); at a level of 300 mg/m2 or higher, 28 patients had dose information (none with cardiomyopathy).
c
Mitoxantrone doses multiplied by a factor of 4 to facilitate comparability to doxorubicin doses.
d
Multiplied by a conversion factor of 4 (eg, mean ratio of 2.6 × 4 = 10.5).