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Cardiac Irradiation in Childhood Leukemia

Am J Dis Child. 1964;108(5):559-565. doi:10.1001/archpedi.1964.02090010561017.
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Infiltration of the heart occurs in one third of patients with leukemia,1,2 but cardiac symptoms appear only occasionally, usually secondary to anemia.3 A few cases of infiltration of the myocardium or pericardium with symptoms of myocarditis,2 heart block,4 or pericarditis5 have been reported. Anterior mediastinal irradiation would seem to be reasonable therapy and has indeed been used in such instances.6,7

Report of a Case  A three-year-old white female was first seen at Children's Memorial Hospital on Sept 20, 1961, with a two year history of anemia. Her only remarkable physical finding was pallor. Laboratory studies (the Table) revealed a pancytopenia. The chest roentgenogram was normal (Fig 1A) and an electrocardiogram was normal (Fig 2A). Surgical sternal and Vim-Silverman iliac crest biopies revealed myelofibrosis.Methyltestosterone-prednisone therapy was started on Dec 10, 1961. Her subsequent course was characterized by hospital admissions for repeated infections, intermittent fever,


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