title: Cardiotoxicity in childhood cancer survivors: strategies for prevention and management.
abstract: Advances in cancer treatment have greatly improved survival rates of children with cancer. However, these same chemotherapeutic or radiologic treatments may result in long-term health consequences. Anthracyclines, chemotherapeutic drugs commonly used to treat children with cancer, are known to be cardiotoxic, but the mechanism by which they induce cardiac damage is still not fully understood. A higher cumulative anthracycline dose and a younger age of diagnosis are only a few of the many risk factors that identify the children at increased risk of developing cardiotoxicity. While cardiotoxicity can develop at anytime, starting from treatment initiation and well into adulthood, identifying the best cardioprotective measures to minimize the long-term damage caused by anthracyclines in children is imperative. Dexrazoxane is the only known agent to date, that is associated with less cardiac dysfunction, without reducing the oncologic efficacy of the anthracycline doxorubicin in children. Given the serious long-term health consequences of cancer treatments on survivors of childhood cancers, it is essential to investigate new approaches to improving the safety of cancer treatments.
authors.affiliation: Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Harake
authors.forename: Vivian I
authors.initials: VI
authors.lastname: Franco
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Henkel
authors.forename: Tracie L
authors.initials: TL
authors.lastname: Miller
authors.forename: Steven E
authors.initials: SE
authors.lastname: Lipshultz
mesh_terms: D052242:Adiponectin / Q000494:pharmacology / Q000627:therapeutic use; D000367:Age Factors; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D018943:Anthracyclines / Q000009:adverse effects*; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use; D000975:Antioxidants / Q000494:pharmacology / Q000627:therapeutic use; D002227:Carbazoles / Q000494:pharmacology / Q000627:therapeutic use; D002308:Cardiolipins; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D000077261:Carvedilol; D004317:Doxorubicin; D004921:Erythropoietin / Q000494:pharmacology / Q000627:therapeutic use; D006321:Heart / Q000187:drug effects*; D006331:Heart Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D006801:Humans; D015227:Lipid Peroxidation; D008081:Liposomes / Q000737:chemistry; D009369:Neoplasms / Q000188:drug therapy* / Q000453:epidemiology; D010879:Piperazines / Q000494:pharmacology / Q000627:therapeutic use; D011412:Propanolamines / Q000494:pharmacology / Q000627:therapeutic use; D011687:Purines / Q000494:pharmacology / Q000627:therapeutic use; D011929:Razoxane / Q000494:pharmacology / Q000627:therapeutic use; D012307:Risk Factors; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000494:pharmacology / Q000627:therapeutic use; D017741:Survivors; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced / Q000517:prevention & control
chemical_list: D052242:Adiponectin; D000806:Angiotensin-Converting Enzyme Inhibitors; D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic; D000975:Antioxidants; D002227:Carbazoles; D002308:Cardiolipins; D002316:Cardiotonic Agents; D008081:Liposomes; D010879:Piperazines; D011412:Propanolamines; D011687:Purines; D013450:Sulfones; D000077261:Carvedilol; D004921:Erythropoietin; D011929:Razoxane; D004317:Doxorubicin; D000068677:Sildenafil Citrate