Early-onset Cardiotoxicity assessment related to anthracycline in children with leukemia. A Prospective Study
Abstract
Background:Acute leukemias are the most frequent malignancies in children. Advances in treatment have improved the overall survival to 80%. Almost 10% of children with cancer develop clinical cardiac toxicity. Total anthracycline cumulative dose is a risk factor for early-onset cardiotoxicity.
Objective:To describe the incidence of early-onset cardiotoxicity in children with acute leukemia treated with chemotherapy.
Methods:A prospective descriptive study of patients >1 y and <18 years diagnosed with acute leukemia. Assessed with electrocardiogram, echocardiography, and blood biomarkers at diagnosis and during the follow-up.
Results:94 patients with acute lymphoblastic leukemia and 18 with acute myeloid leukemia were included. 20 patients (17.9%) developed early-onset cardiotoxicity. Statistically significant data was seen after anthracycline dose >150 mg/m2, between the first echocardiographic evaluation and posterior analyses in the left ventricular fraction ejection with Teicholz p 0.05, Simpson p 0.018 and GLS p 0.004. In this study, there was no relation between blood biomarkers and cardiotoxicity.
Conclusions:Cancer therapeutic-related cardiac dysfunction is related to anthracycline cumulative dose. In this study, echocardiographic follow-up was useful to predict risk factors for early cardiac dysfunction.
Authors
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Keywords
- child, leukemia, anthracyclines, antineoplastic agents, ventricular dysfunction, echocardiography, drug therapy
- child
- leukemia
- anthracyclines
- antineoplastic agents
- ventricular dysfunction
- echocardiography
- drug therapy
Author Biographies
, Universidad Nacional de Colombia, Facultad de Medicina, Departamento de Pediatría, Bogotá, Colombia - Fundación Hospital Pediátrico de la Misericordia-HOMI, Oncohematología pediátrica, Bogotá Colombia
She is a physician from El Bosque University, a Pediatrician and Pediatric Oncohematologist from the National University of Colombia, Specialist in Bioethics, El Bosque University. During her professional life as a pediatric oncohematologist, she has worked at HOMI Fundación Hospital de La Misericordia, and currently, she is
Titular Professor of the Department of Pediatrics of the Universidad Nacional de Colombia. The study of acute leukemias in children has been one of her interests. She was the Guías de Práctica Clínica de diagnóstico y tratamiento de Leucemias Agudas y Linfomas en niños niñas. She was part of the research team that won the National Medicine Award in 2012 for Research in Acute Lymphoid Leukemia. She has been a consultant for the Colombian Cuenta de Alto Costo in the field of acute leukemias in children.
https://orcid.org/0000-0001-7429-6850
, Fundación Hospital Pediátrico de la Misericordia-HOMI, Cardiología pediátrica, Bogotá Colombia
https://orcid.org/0000-0002-8443-9496
, Universidad Nacional de Colombia, Facultad de Medicina, Departamento de Pediatría, Bogotá, Colombia
https://orcid.org/0000-0003-2292-8099
, Fundación Hospital Pediátrico de la Misericordia-HOMI, Cardiología pediátrica, Bogotá Colombia
https://orcid.org/0000-0001-5572-897X
, Universidad Nacional de Colombia, Universidad Nacional de Colombia, Facultad de Medicina, Departamento de Pediatría, Bogotá, Colombia, 2 Fundación Hospital Pediátrico de la Misericordia-HOMI, Oncohematología pediátrica, Bogotá Colombia,
https://orcid.org/0000-0003-1575-7690
, Universidad Nacional de Colombia, Universidad Nacional de Colombia, Facultad de Medicina, Departamento de Pediatría, Bogotá, Colombia, 2 Fundación Hospital Pediátrico de la Misericordia-HOMI, Oncohematología pediátrica, Bogotá Colombia
https://orcid.org/0000-0001-6238-9750
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