Document Detail

Present risk of anthracycline or radiation-induced cardiac sequelae following therapy of malignancies in children and adolescents.
MedLine Citation:
PMID:  19437364     Owner:  NLM     Status:  MEDLINE    
Anthracyclines are very potent drugs in the therapy of malignancies in childhood. The major dose limiting adverse effect of these drugs is the risk of dilated cardiomyopathy. We performed a retrospective study on 168 patients who were treated with anthracyclines for a malignant disease with or without chest radiation at the department of Pediatric Hematology and Oncology at the University of Duesseldorf between 2000 and 2004. During and after chemotherapy the patients were screened by echocardiography and ECG examinations prior to each administration of anthracyclines. Only four patients presented with adverse cardiac events, one of whom developed acute cardiac failure. This patient was additionally treated with chest radiation. Three of the four patients showed intermittent arrhythmias, mainly supraventricular tachycardia. One of them presented with atrial ectopic tachycardia and left ventricular dysfunction. We conclude that the frequency of cardiac sequelae after chemotherapy with anthracyclines is low under present guidelines. Detection of early cardiac sequelae may be more difficult than in the past. Only one patient with cardiac sequelae in our study group was diagnosed by regular performed examinations for cardiac sequelae of chemotherapy. We therefore need to modify our screening methods to increase the effectiveness of detection of cardiac dysfunction prior to clinical manifestation.
C Chen; A Heusch; B Donner; G Janssen; U Göbel; K G Schmidt
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Publication Detail:
Type:  Journal Article     Date:  2009-05-12
Journal Detail:
Title:  Klinische Pädiatrie     Volume:  221     ISSN:  1439-3824     ISO Abbreviation:  Klin Padiatr     Publication Date:    2009 May-Jun
Date Detail:
Created Date:  2009-05-13     Completed Date:  2009-08-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0326144     Medline TA:  Klin Padiatr     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  162-6     Citation Subset:  IM    
Department of Pediatric Cardiology and Pneumology, University Medical Center, Heinrich-Heine-University, Duesseldorf, Germany.
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MeSH Terms
Anthracyclines / therapeutic use,  toxicity*
Antibiotics, Antineoplastic / therapeutic use,  toxicity*
Antineoplastic Combined Chemotherapy Protocols / therapeutic use,  toxicity*
Arrhythmias, Cardiac / chemically induced,  diagnosis
Child, Preschool
Combined Modality Therapy / adverse effects
Dose-Response Relationship, Drug
Echocardiography / drug effects,  radiation effects
Electrocardiography / drug effects,  radiation effects
Heart / drug effects*,  radiation effects*
Heart Failure / chemically induced,  diagnosis
Mass Screening
Neoplasms / drug therapy*,  radiotherapy*
Radiation Injuries / diagnosis,  etiology*
Radiotherapy Dosage
Retrospective Studies
Tachycardia, Supraventricular / chemically induced,  diagnosis
Ventricular Dysfunction, Left / chemically induced,  diagnosis
Reg. No./Substance:
0/Anthracyclines; 0/Antibiotics, Antineoplastic

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