Clinical heart failure during pregnancy and delivery in a cohort of female childhood cancer survivors treated with anthracyclines.
The cumulative incidence of peripartum anthracycline-induced clinical heart failure (A-CHF) was evaluated in a cohort of 53 childhood cancer survivors who had delivered one or more children. None of them developed peripartum A-CHF (cumulative incidence 0%; 95% confidence interval (CI) 0-5.7%). The mean follow-up time after the first administration of anthracycline therapy was 20.3 years. They received a mean cumulative anthracycline dose of 267 mg/m2. It is worth noticing that even 2 patients with A-CHF before pregnancy did not develop peripartum A-CHF. Since there were no cases of peripartum A-CHF in our cohort, it was not possible to evaluate associated risk factors. In conclusion, this study demonstrates a low risk of developing peripartum A-CHF in childhood cancer survivors. However, more cohort studies with adequate power and long-term follow-up are needed to reliably evaluate the cumulative incidence of peripartum anthracycline-induced cardiotoxicity (both clinical and asymptomatic) and associated risk factors.
van Dalen
Elvira C
EC
Department of Paediatric Oncology, Room F8-257, Emma Children's Hospital/Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. e.c.vandalen@amc.uva.nl
van der Pal
Helena J H
HJ
van den Bos
Cor
C
Kok
Wouter E M
WE
Caron
Huib N
HN
Kremer
Leontien C M
LC
D000293:Adolescent; D000328:Adult; D018943:Anthracyclines / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000139:chemically induced*; D006801:Humans; D007223:Infant; D009369:Neoplasms / Q000188:drug therapy; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000139:chemically induced*; D012307:Risk Factors; D017741:Survivors
D018943:Anthracyclines