Which statement is correct regarding daunorubicin and cardiotoxicity?

• A. Daunorubicin can cause dose-dependent cardiomyopathy
• B. Daunorubicin causes nephrotoxicity
• C. Daunorubicin has no cardiac effects
• D. Daunorubicin only causes acute toxicity

Answer: (A)

Daunorubicin is an anthracycline, and its most important toxicity is cardiotoxicity that increases with the total amount given over time. The heart damage tends to be dose-dependent and cumulative, leading to dilated cardiomyopathy and potentially heart failure. This risk can persist or emerge months to years after therapy, and the damage is often not fully reversible. Because of that dose-related risk, the correct statement is that daunorubicin can cause dose-dependent cardiomyopathy. It is not primarily nephrotoxic, so claiming nephrotoxicity isn’t accurate, and it certainly does have cardiac effects, so saying there are no cardiac effects is incorrect. The idea that toxicity is limited to acute effects is false as well, since chronic cardiomyopathy is a well-described long-term consequence. In clinical practice, cardiac function is monitored (e.g., with echocardiography), cumulative dose limits are observed, and protective strategies like considering dexrazoxane can be used in selected cases to reduce risk.