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Late anthracycline cardiotoxicity after childhood cancer : A prospective longitudinal study

✍ Scribed by Keld Sorensen; Gill A. Levitt; Catherine Bull; Inge Dorup; Ian D. Sullivan


Book ID
102107348
Publisher
John Wiley and Sons
Year
2003
Tongue
English
Weight
104 KB
Volume
97
Category
Article
ISSN
0008-543X

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✦ Synopsis


Abstract

BACKGROUND

The objective of the current study was to examine the risk factors for progression in severity of anthracycline‐induced cardiac dysfunction, thereby providing information that is useful in refining cancer treatment regimes and guiding follow‐up.

METHODS

Serial echocardiograms were performed on 101 acute lymphoblastic leukemia survivors and 83 Wilms tumor survivors after a mean interval of 6.2 years and 6.7 years since last anthracycline dose, respectively, at first study, and after 10.3 years and 11.1 years, respectively, at second study. The paired data were contrasted with data from 100 normal subjects, and potential correlations with follow‐up interval, cumulative dose, cancer diagnosis, gender, age at diagnosis, and growth were explored using univariate and multiple regression techniques.

RESULTS

The most important predictor of worsening cardiac performance was total anthracycline dose. As a group, patients receiving < 240 mg/m^2^ showed no deterioration of left ventricular end systolic stress at > 10 years from the end of treatment.

CONCLUSIONS

Survivors who have received low‐dose anthracycline require cardiac surveillance infrequently. In good prognosis tumors, cumulative anthracycline dose should be maintained at < 250 mg/m^2^. Cancer 2003;97:1991–8. © 2003 American Cancer Society.

DOI 10.1002/cncr.11274


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