title: Cardiac function in survivors of acute lymphoblastic leukaemia and Hodgkin's lymphoma.
abstract: OBJECTIVE
  The study objective was to assess plasma N-terminal-pro-brain natriuretic peptide (BNP) levels and to evaluate left ventricular mass as well as left ventricular systolic and diastolic functions in 44 children who had undergone treatment for acute lymphoblastic leukaemia and Hodgkin's lymphoma, with regard to gender, age at disease onset, time that had passed since therapy completion, cumulative dose of antracyclines and mediastinal radiotherapy applied.
  
  
  METHODS
  The median levels of pro-BNP were found to be higher in the whole study group as compared with the control (55.9 ± 53.1 ng/mL vs. 38.5 ± 47.7 ng/mL, P= 0.059). The pro-BNP values >80.0 ng/mL (standard deviation score (SDS)) were noted in 11/44 patients, including those exceeding 115.0 ng/mL (2 SDS) - in 6/44 patients.
  
  
  RESULTS
  No correlation was observed of pro-BNP levels with the accumulated dose of antracyclines (r=-0.42, P= 0.79) or mediastinal radiotherapy (r= 0.197, P= 0.2). However, negative correlation was found between pro-BNP and the time that had passed since therapy completion (r=-0.378, P= 0.009). In echocardiography, shortening and ejection fractions remained normal, whereas the indexed stroke volume was below 40 mL/m(2) in 16/44 patients. The E/A index below 1.5 was found in 6/44 cases. The left ventricular systolic mass remained within the normal range. Negative correlation was noted between isovolumetric diastolic time and pro-BNP level.
  
  
  CONCLUSIONS
  Increased levels of pro-BNP after anti-cancer treatment with the involvement of cardiotoxic substances may indicate the first symptoms of myocardial dysfunction, despite the lack of major echocardiographic disorders.
authors.affiliation: Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Bialystok, Poland. rybak@umwb.edu.pl
authors.forename: Maryna
authors.initials: M
authors.lastname: Krawczuk-Rybak
authors.forename: Lucja
authors.initials: L
authors.lastname: Dakowicz
authors.forename: Andrzej
authors.initials: A
authors.lastname: Hryniewicz
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Maksymiuk
authors.forename: Beata
authors.initials: B
authors.lastname: Zelazowska-Rutkowska
authors.forename: Jolanta
authors.initials: J
authors.lastname: Wysocka
mesh_terms: D000293:Adolescent; D018943:Anthracyclines / Q000009:adverse effects*; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D059248:Chemoradiotherapy / Q000009:adverse effects*; D002648:Child; D003971:Diastole / Q000187:drug effects; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006689:Hodgkin Disease / Q000097:blood / Q000628:therapy*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000628:therapy*; D011832:Radiation Injuries; D013318:Stroke Volume / Q000187:drug effects; D016277:Ventricular Function, Left / Q000187:drug effects*; D055815:Young Adult
chemical_list: D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic; D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain