TY - JOUR
T1 - Anthracycline cardiotoxicity in survivors of childhood cancer
T2 - Clinical course, protection, and treatment
AU - Bansal, Neha
AU - Franco, Vivian I.
AU - Lipshultz, Steven E.
N1 - Funding Information:
Some of the studies presented here were funded in part by grants from the National Institutes of Health (HL072705, HL078522, HL053392, CA127642, CA068484, HD052104, AI50274, HD052102, HL087708, HL079233, HL004537, HL087000, HL007188, HL094100, HL095127, and HD80002), the Children’s Cardiomyopathy Foundation, the Women’s Cancer Association of the University of Miami, the Lance Armstrong Foundation, the STOP Children’s Cancer Foundation, the Scott Howard Fund, and the Michael Garil Fund. Clinigen had no role in any part of this work.
Funding Information:
Dr. Steven Lipshultz was partially funded by grants from Pfizer and Roche Diagnostics for some of the studies presented in this review. He was also a paid consultant by Clinigen for a meeting of experts on dexrazoxane. All other authors have nothing to disclose.
Publisher Copyright:
© 2014.
PY - 2014
Y1 - 2014
N2 - Childhood cancer survivors are now living longer as a result of advancements in cancer treatment, but not without consequences. Cardiovascular disease is the leading non-cancer-related cause of morbidity and mortality in long-term survivors of childhood cancer. Cardiotoxicity associated with cancer treatment in children can be pervasive, persistent, and progressive. Serum cardiac biomarker concentrations during therapy can predict late cardiotoxicity; although there is still a need for validated cardiac monitoring guidelines. The cardioprotective strategy of continuous infusion of doxorubicin, while showing short-term benefit in adults, provides no long-term cardioprotection or improvement in event-free survival over bolus-infusion in children with a diagnosis of acute lymphoblastic leukemia. However, dexrazoxane protects the heart from the cardiotoxic effects of anthracycline treatment and does not interfere with oncologic efficacy or increase the risk of second malignancies. The emerging field of cardio-oncology emphasizes the need for collaborations between cardiologists and oncologists to find a balance between oncologic efficacy and the risks of cardiotoxicity to maximize the quality of life and survival for long-term survivors of childhood cancer.
AB - Childhood cancer survivors are now living longer as a result of advancements in cancer treatment, but not without consequences. Cardiovascular disease is the leading non-cancer-related cause of morbidity and mortality in long-term survivors of childhood cancer. Cardiotoxicity associated with cancer treatment in children can be pervasive, persistent, and progressive. Serum cardiac biomarker concentrations during therapy can predict late cardiotoxicity; although there is still a need for validated cardiac monitoring guidelines. The cardioprotective strategy of continuous infusion of doxorubicin, while showing short-term benefit in adults, provides no long-term cardioprotection or improvement in event-free survival over bolus-infusion in children with a diagnosis of acute lymphoblastic leukemia. However, dexrazoxane protects the heart from the cardiotoxic effects of anthracycline treatment and does not interfere with oncologic efficacy or increase the risk of second malignancies. The emerging field of cardio-oncology emphasizes the need for collaborations between cardiologists and oncologists to find a balance between oncologic efficacy and the risks of cardiotoxicity to maximize the quality of life and survival for long-term survivors of childhood cancer.
KW - Anthracyclines
KW - Cardiac late effects
KW - Cardiotoxicity
KW - Childhood cancer
KW - Childhood cancer survivors
KW - Dexrazoxane
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U2 - 10.1016/j.ppedcard.2014.09.012
DO - 10.1016/j.ppedcard.2014.09.012
M3 - Review article
AN - SCOPUS:84925943320
SN - 1058-9813
VL - 36
SP - 11
EP - 18
JO - Progress in Pediatric Cardiology
JF - Progress in Pediatric Cardiology
IS - 1-2
ER -
