title: Cardiomyopathy in Childhood Cancer Survivors: Lessons from the Past and Challenges for the Future.
abstract: Childhood cancer survivors are at substantial risk for cancer treatment-related cardiomyopathy. Identification of those at highest risk has presented a longstanding challenge for survivorship researchers. To date, risk stratification approaches to screening and subsequent intervention have largely been driven by demographic and treatment-related exposures, possibly missing an opportunity for a more personalized approach. A growing body of literature suggests associations between cardiomyopathy and a number of genetic and acquired risk factors, supporting a need to incorporate these data into existing surveillance and intervention approaches. Efforts to reduce or eliminate modifiable cardiovascular risk factors are needed; however, the impact of these modifications remains to be seen. Moreover, challenges surrounding identification of effective cardiomyopathy treatment strategies in cancer survivors are ongoing. Despite these uncertainties, more accurate identification of those at highest risk and implementation of early and effective interventions for those with disease will lead to improved outcomes for childhood cancer survivors.
authors.affiliation: Department of Oncology and Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Ehrhardt
authors.affiliation: Division of Hematology, Oncology and Bone Marrow Transplantation, Children's Mercy Hospital, Kansas City, MO, USA.
authors.forename: Joy M
authors.initials: JM
authors.lastname: Fulbright
authors.affiliation: Department of Population Sciences, City of Hope Comprehensive Cancer Center, 1500 East Duarte Rd, Duarte, CA, 91010-3000, USA. sarmenian@coh.org.
authors.forename: Saro H
authors.initials: SH
authors.lastname: Armenian
mesh_terms: D018943:Anthracyclines / Q000009:adverse effects / Q000627:therapeutic use; D009202:Cardiomyopathies / Q000139:chemically induced / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D066126:Cardiotoxicity / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D010372:Pediatrics; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors; D017741:Survivors; D016896:Treatment Outcome
chemical_list: D018943:Anthracyclines
keywords: Anthracyclines; Cardiomyopathy; Childhood cancer survivors; Mediastinal radiation; Prevention; Risk stratification; Screening; Treatment