title: Management of asymptomatic anthracycline-induced cardiac damage after treatment for childhood cancer: a postal survey among Dutch adult and pediatric cardiologists.
abstract: Asymptomatic anthracycline-induced cardiac damage (A-CD) is a serious problem among young childhood cancer survivors. The aim of this survey was to assess the current treatment policy in these patients in the Netherlands. A questionnaire was sent to all 136 departments of adult or pediatric cardiology in the Netherlands. It was returned by 61% of the departments. Sixty-six percent of the respondents started medical treatment (ie, an ACE inhibitor and/or a beta-blocker) in childhood cancer survivors with asymptomatic A-CD. Fifty-eight percent of the respondents indicated that their treatment decision was based on published findings in the literature, but none of them referred to studies evaluating the treatment of asymptomatic A-CD. A majority of adult and pediatric cardiologists started medical treatment in childhood cancer survivors with asymptomatic A-CD without knowledge of the benefits and risks of treatment in this patient group. Before ACE inhibitors and/or beta-blockers can be recommended as routine practice in childhood cancer survivors with asymptomatic A-CD, randomized controlled trials should be performed. Until then, the authors recommend centralizing the treatment of childhood cancer survivors with asymptomatic A-CD in a specialized center to cluster the available knowledge and experience.
authors.affiliation: Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands. e.c.vandalen@amc.uva.nl
authors.forename: Elvira C
authors.initials: EC
authors.lastname: van Dalen
authors.forename: Heleen J H
authors.initials: HJ
authors.lastname: van der Pal
authors.forename: Johannes B
authors.initials: JB
authors.lastname: Reitsma
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: de Winter
authors.forename: Wim A
authors.initials: WA
authors.lastname: Helbing
authors.forename: Jaap
authors.initials: J
authors.lastname: Ottenkamp
authors.forename: Huib N
authors.initials: HN
authors.lastname: Caron
authors.forename: Leontien C M
authors.initials: LC
authors.lastname: Kremer
mesh_terms: D000328:Adult; D000367:Age Factors; D018943:Anthracyclines / Q000009:adverse effects*; D002648:Child; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006321:Heart / Q000187:drug effects*; D006801:Humans; D008511:Medicine; D009206:Myocardium / Q000473:pathology*; D009369:Neoplasms / Q000188:drug therapy*; D009426:Netherlands; D011177:Postal Service; D013038:Specialization; D011795:Surveys and Questionnaires
chemical_list: D018943:Anthracyclines