Monitoring for cardiovascular disease in survivors of childhood cancer: report from the Cardiovascular Disease Task Force of the Children's Oncology Group.
Curative therapy for childhood cancer has improved significantly in the last 2 decades such that, at present, approximately 80% of all children with cancer are likely to survive > or = 5 years after diagnosis. Prevention, early diagnosis, and treatment of long-term sequelae of therapy have become increasingly more significant as survival rates continue to improve. Cardiovascular disease is a well-recognized cause of increased late morbidity and mortality among survivors of childhood cancer. The Children's Oncology Group Late Effects Committee and Nursing Discipline and Patient Advocacy Committee have recently developed guidelines for follow-up of long-term survivors of pediatric cancer. A multidisciplinary task force critically reviewed the existing literature to evaluate the evidence for the cardiovascular screening recommended by the Children's Oncology Group guidelines. In this review we outline the clinical manifestations of late cardiovascular toxicities, suggest modalities and frequency of monitoring, and address some of the controversial and unresolved issues regarding cardiovascular disease in childhood cancer survivors.
Shankar
Sadhna M
SM
Division of Pediatric Hematology/Oncology, Department of Pediatrics, Vanderbilt University, Nashville, Tennessee 37232-6310, USA. sadhnamd@gmail.com
Marina
Neyssa
N
Hudson
Melissa M
MM
Hodgson
David C
DC
Adams
M Jacob
MJ
Landier
Wendy
W
Bhatia
Smita
S
Meeske
Kathleen
K
Chen
Ming Hui
MH
Kinahan
Karen E
KE
Steinberger
Julia
J
Rosenthal
David
D
D018943:Anthracyclines / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002561:Cerebrovascular Disorders / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000528:radiation effects; D006331:Heart Diseases / Q000139:chemically induced* / Q000209:etiology; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D011832:Radiation Injuries / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects*; D017741:Survivors
D018943:Anthracyclines; D000970:Antineoplastic Agents