title: [Treatment-related cardiotoxicity in childhood cancer survivors: Risk factors and follow-up].
abstract: Anthracycline-induced cardiotoxicity (ACT) is a severe complication in children and young adults that may lead to congestive heart failure. Some risk factors have been identified: high anthracycline cumulative dose, high radiation dose delivered on the cardiac area, or young age during the treatment. Primary prevention is not clearly defined in children. The dexrazoxane iron chelator seems to be interesting based on its short-term cardioprotective property in patients receiving doxorubicin-containing regimens. However, its long-term benefits remain to be determined, as well as the risk of secondary cancer. Childhood cancer survivors treated with anthracyclines are annually followed in the long-term. Trans-thoracic echocardiography is classically performed every 2 to 5 years for assessing the ventricular hemodynamics and function. Recent modern techniques including echocardiography with strain assessment and cardiac MRI seems to be promising for an early detection of myocardial impairment. Further studies are mandatory for validating their usefulness in the setting of anthracycline-induced cardiomyopathy. Recently, ACT predisposing variants in genes involved in oxydative stress and in metabolism and transport of anthracyclines have been identified. Their use in clinical practice could improve ACT risk stratification of children treated with anthracyclines-containing regimens. Predictive models combining replicated genetic variants and clinical factors need to be validated with the challenge to identify patients at high risk of cardiomyopathy. The objective is to personalize treatment strategy according to individual genetic background.
authors.affiliation: Département de cancérologie de l'enfant et de l'adolescent, Gustave-Roussy, université Paris-Saclay, 114, rue Edouard-Vaillant, 94805 Villejuif, France. Electronic address: brice.fresneau@gustaveroussy.fr.
authors.forename: B
authors.initials: B
authors.lastname: Fresneau
authors.affiliation: Département de cancérologie de l'enfant et de l'adolescent, Gustave-Roussy, université Paris-Saclay, 114, rue Edouard-Vaillant, 94805 Villejuif, France.
authors.forename: C
authors.initials: C
authors.lastname: Fayech
authors.affiliation: Département de cancérologie de l'enfant et de l'adolescent, Gustave-Roussy, université Paris-Saclay, 114, rue Edouard-Vaillant, 94805 Villejuif, France.
authors.forename: T
authors.initials: T
authors.lastname: Butel
authors.affiliation: Équipe 3 - épidémiologie des radiations, épidémiologie clinique et des survivants d'un cancer, centre de recherche en épidémiologie et santé des populations, Inserm U1018, Gustave-Roussy, 94805 Villejuif, France.
authors.forename: N
authors.initials: N
authors.lastname: Haddy
authors.affiliation: Département de cancérologie de l'enfant et de l'adolescent, Gustave-Roussy, université Paris-Saclay, 114, rue Edouard-Vaillant, 94805 Villejuif, France.
authors.forename: D
authors.initials: D
authors.lastname: Valteau-Couanet
authors.affiliation: Service d'imagerie médicale, hôpital Bichat, AP-HP, 75018 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Ou
mesh_terms: D000328:Adult; D017668:Age of Onset; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D009202:Cardiomyopathies / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D066126:Cardiotoxicity; D002648:Child; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy* / Q000453:epidemiology; D011832:Radiation Injuries / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D011878:Radiotherapy / Q000009:adverse effects*; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data
chemical_list: D000903:Antibiotics, Antineoplastic
keywords: Anthracycline; Anthracyclines; Cancers de l’enfant; Cardiomyopathies; Cardiomyopathy; Coronaropathie; Coronary lesions; Irradiation; Neoplasia of the young; Radiotherapy