Late cardiotoxic effects of anthracycline chemotherapy in childhood malignancies.
OBJECTIVE
To determine the frequency of changes in left ventricular function in patients, at least 5 years after completion of anthracycline-therapy for childhood malignancy.


METHODS
Echocardiographic examination was performed on 58 patients (36 males and 22 females) with mean age of 17.5+/-4.6 years (range 9-29 years, median 17.5 years). The control group was 58 healthy age and sex matched children.


RESULTS
The age at the time of diagnosis and start of treatment ranged from 2 to 14 years with a median of 6 years. The time of follow-up was between 5 to 22 years with a median of 9 years. The cumulative dose of anthracycline was 30 to 557 mg/m2, median 128.5 mg/m2. All the patients were asymptomatic. Abnormal systolic and/or diastolic functions were found in 29 (50%) patients. We found a strong correlation between systolic and diastolic cardiac dysfunction and longer time of follow-up (P = 0.02 and p = 0.04), respectively, but not a relation to the cumulative dose, sex, and age at diagnosis.


CONCLUSIONS
The data showed a relatively high incidence of subclinical cardiotoxicity in long-term survivors. The significance of this subclinical cardiotoxicity on the morbidity and mortality of patients should be followed in the future.
Roodpeyma
Shahla
S
Department of Pediatrics, Taleghani Medical Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Moussavi
Farideh
F
Kamali
Zinat
Z
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D018943:Anthracyclines / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D054715:Cardiotoxins / Q000009:adverse effects*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003971:Diastole; D005260:Female; D006352:Heart Ventricles / Q000187:drug effects*; D006801:Humans; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D011446:Prospective Studies; D013223:Statistics as Topic; D017741:Survivors; D013599:Systole; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced*; D055815:Young Adult
D018943:Anthracyclines; D000970:Antineoplastic Agents; D054715:Cardiotoxins