title: Can anthracycline therapy for pediatric malignancies be less cardiotoxic?
abstract: Anthracyclines have a central role in the treatment of cancer in pediatric patients but confer an increased risk of cardiac dysfunction. Several strategies have been employed to help reduce anthracycline-induced cardiotoxicity, including pretreating the patient with the iron chelator dexrazoxane and infusing the dose of anthracycline over a longer period. Much focus has also been placed on the development of methods that decrease the toxicity of parent compounds, specifically through the use of drug carriers such as liposomes, and on the development of new, potentially less toxic anthracycline derivatives, such as amrubicin and pixantrone. We provide a review of these strategies, focusing on studies in pediatric patients when available, and support the idea that anthracycline therapy can be less cardiotoxic in pediatric patients.
authors.affiliation: Children's Mercy Hospitals and Clinics, Kansas City, MO 64108, USA. jmfulbright@cmh.edu
authors.forename: Joy M
authors.initials: JM
authors.lastname: Fulbright
authors.forename: Winston
authors.initials: W
authors.lastname: Huh
authors.forename: Pete
authors.initials: P
authors.lastname: Anderson
authors.forename: Joya
authors.initials: J
authors.lastname: Chandra
mesh_terms: D000293:Adolescent; D000328:Adult; D018943:Anthracyclines / Q000008:administration & dosage / Q000032:analysis / Q000037:antagonists & inhibitors*; D002648:Child; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000633:toxicity; D018450:Disease Progression; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004334:Drug Administration Schedule; D004337:Drug Carriers / Q000008:administration & dosage / Q000633:toxicity; D054796:Drug Dosage Calculations; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control; D006321:Heart / Q000187:drug effects* / Q000503:physiopathology; D006331:Heart Diseases / Q000139:chemically induced / Q000517:prevention & control; D006333:Heart Failure / Q000139:chemically induced / Q000517:prevention & control; D006801:Humans; D007502:Iron Chelating Agents / Q000008:administration & dosage; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D011929:Razoxane / Q000008:administration & dosage; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D018943:Anthracyclines; D003692:Delayed-Action Preparations; D004337:Drug Carriers; D007502:Iron Chelating Agents; D011929:Razoxane; D004317:Doxorubicin
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