Early-onset Cardiotoxicity assessment related to anthracycline in children with leukemia. A Prospective Study

Ballesteros, Adriana Linares; Lobo, Roy Sanguino; Valencia, Juan Camilo Villada; Leal, Oscar Arévalo; Hernández, Darwin; Barrios, Nelson Aponte; Ramírez, Iván Perdomo

doi:10.25100/cm.v52i1.4542

Cited by 3 publications

(3 citation statements)

References 43 publications

(53 reference statements)

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“…Linares et al (2021) shows patients with high-risk leukemia had Pericardial effusion (6.3%), Valvular insufficiency (1.8%) and Pulmonary hypertension (8.0%) in echocardiographic findings and cardiotoxicity only related to pulmonary hypertension (p=0.038). 14 These results indicate that chemotherapy leads to increased tricuspid valve regurgitation after treatment.…”

Section: Discussionmentioning

confidence: 90%

“…Similar findings were also observed by Linares et al ( 2021) among high risk ALL children's who were treated with daunorubicin. 14 No significant alteration has been seen in troponin I before and after induction. Moreover, no relationship was seen between alteration of troponin I and the presence of cardiac involvement.…”

Section: Discussionmentioning

confidence: 95%

“…Linares et al (2021) reported cardiotoxicity was 13.5% of patients with acute lymphoblastic leukemia. 14 Annur et al 2021 found 21.6% of children with high risk ALL treated with daunorubicin during the induction period experienced cardiac dysfunction. 15 This study shows after induction Troponin I did not significantly raise from baseline (P= 0.581).…”

Section: Discussionmentioning

confidence: 99%

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Rate of Cardiotoxicity in Childhood Acute Lymphoblastic Leukemia Treated with Daunorubicin Using Echocardiography and Troponin I

Sultana,

Chowdhury,

Islam

et al. 2023

Univ. Heart J.

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Background and Aim: Acute lymphoblastic leukemia (ALL) is the commonest malignancy in childhood. Childhood ALL Survivors have a lifelong increased risk for cardiovascular morbidity and mortality compared to the general population, mainly caused by chemotherapy with daunorubicin. The aim of the study is to detect the rate of daunorubicin induced cardiotoxicity in children with acute lymphoblastic leukemia during induction phase chemotherapy. Meterials & Methods : This prospective observational study was conducted in the department of Pediatric Hematology and Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU) on 40 newly diagnosed patients of ALL aged between 1 to17.9 years who got daunorubicin during induction. Complete blood count and echocardiography were done and troponin I was measured in all patients before and after completion of induction period. Result: Of the 40 patients, 8 patients (20%) had developed cardiotoxicity evidenced by reduction of left ventricular ejection fraction (LVEF) in echocardiography. Baseline LVEF was 68.80±5.98% which was then reduced to 65.32±7.07% after induction phase of chemotherapy (p=0.023). No significant alteration of troponin I was seen (P= 0.581) between baseline and after completion of induction. Total WBC count and hemoglobin had a significant difference (P<0.05) between baseline and after induction period. Male patients had a greater risk of developing cardiotoxicity than females but statistically was not significant (P=0.643). There was no significant association between age of the patients and cardiotoxicity (P=0.112).Cardiotoxicity was seen higher in patient with initial high WBC count (p=0.039). Echocardiography also reveled increased tendency of mitral regurgitation and left ventricular hypertrophy after induction phase chemotherapy. Conclusion: This study showed the rate of cardiotoxicity was 20% in ALL patients treated with daunorubicin. It also found that LVEF was decreased during therapy.Echocardiography can be used to detect early cardiotoxicity induced by daunorubicin. University Heart Journal 2023; 19(1): 20-25

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Rate of Cardiotoxicity in Childhood Acute Lymphoblastic Leukemia Treated with Daunorubicin Using Echocardiography and Troponin I

Sultana,

Chowdhury,

Islam

et al. 2023

Univ. Heart J.

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Correlating decline in left ventricular ejection fraction and longitudinal strain in pediatric cancer patients

Mejia

Pignatelli

Rainusso

et al. 2022

Int J Cardiovasc Imaging

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Acute and early-onset cardiotoxicity in children and adolescents with cancer: a systematic review

Kouwenberg,

van Dalen,

Feijen

et al. 2023

BMC Cancer

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Background Cardiotoxicity is among the most important adverse effects of childhood cancer treatment. Anthracyclines, mitoxantrone and radiotherapy involving the heart are its main causes. Subclinical cardiac dysfunction may over time progress to clinical heart failure. The majority of previous studies have focused on late-onset cardiotoxicity. In this systematic review, we discuss the prevalence and risk factors for acute and early-onset cardiotoxicity in children and adolescents with cancer treated with anthracyclines, mitoxantrone or radiotherapy involving the heart. Methods A literature search was performed within PubMed and reference lists of relevant studies. Studies were eligible if they reported on cardiotoxicity measured by clinical, echocardiographic and biochemical parameters routinely used in clinical practice during or within one year after the start of cancer treatment in ≥ 25 children and adolescents with cancer. Information about study population, treatment, outcomes of diagnostic tests used for cardiotoxicity assessment and risk factors was extracted and risk of bias was assessed. Results Our PubMed search yielded 3649 unique publications, 44 of which fulfilled the inclusion criteria. One additional study was identified by scanning the reference lists of relevant studies. In these 45 studies, acute and early-onset cardiotoxicity was studied in 7797 children and adolescents. Definitions of acute and early-onset cardiotoxicity prove to be highly heterogeneous. Prevalence rates varied for different cardiotoxicity definitions: systolic dysfunction (0.0–56.4%), diastolic dysfunction (30.0–100%), combinations of echocardiography and/or clinical parameters (0.0–38.1%), clinical symptoms (0.0–25.5%) and biomarker levels (0.0–37.5%). Shortening fraction and ejection fraction significantly decreased during treatment. Cumulative anthracycline dose proves to be an important risk factor. Conclusions Various definitions have been used to describe acute and early-onset cardiotoxicity due to childhood cancer treatment, complicating the establishment of its exact prevalence. Our findings underscore the importance of uniform international guidelines for the monitoring of cardiac function during and shortly after childhood cancer treatment.

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Early-onset Cardiotoxicity assessment related to anthracycline in children with leukemia. A Prospective Study

Cited by 3 publications

References 43 publications

Rate of Cardiotoxicity in Childhood Acute Lymphoblastic Leukemia Treated with Daunorubicin Using Echocardiography and Troponin I

Rate of Cardiotoxicity in Childhood Acute Lymphoblastic Leukemia Treated with Daunorubicin Using Echocardiography and Troponin I

Correlating decline in left ventricular ejection fraction and longitudinal strain in pediatric cancer patients

Acute and early-onset cardiotoxicity in children and adolescents with cancer: a systematic review

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