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Risk factors for cardiac dysfunction in children on treatment for cancer at Kenyatta National Hospital, Nairobi

M Shiroya-Wandabwa1, C Yuko-Jowi, R Nduati

  • 1International Centre for AIDS Programs, Kenya.

East African Medical Journal
|May 20, 2011
PubMed

Insights

Nearly 30% of pediatric oncology patients on treatment had abnormal cardiac function. High cumulative anthracycline doses above 200 mg/m2 significantly increased the risk of cardiac dysfunction.

Area of Science:

  • Cardiology
  • Pediatric Oncology
  • Clinical Research

Background:

  • Cancer treatments, particularly anthracyclines, can lead to cardiac dysfunction in children.
  • Early identification and risk factor assessment are crucial for managing cardiotoxicity in pediatric cancer patients.

Purpose of the Study:

  • To determine the prevalence of abnormal cardiac function in pediatric oncology patients undergoing treatment.
  • To identify risk factors associated with cardiac dysfunction in this vulnerable population.

Main Methods:

  • A descriptive cross-sectional study with a nested case-control design was conducted.
  • Patients were assessed at Kenyatta National Hospital between February and April 2006.
  • Left ventricular dysfunction was defined by ejection fraction (EF) <55% or fractional shortening (FS) <29%.

Main Results:

  • The point prevalence of cardiac dysfunction was 29% (95% CI 21.2-37.9) among 111 enrolled patients.
  • Cumulative anthracycline dose emerged as a significant risk factor for cardiac dysfunction.
  • An attributable risk of 77% for cardiac dysfunction was observed with cumulative anthracycline doses exceeding 200 mg/m2.

Conclusions:

  • Serial echocardiography is recommended for early detection of cardiac dysfunction in at-risk pediatric oncology patients.
  • Alternative treatment protocols are advised when cumulative anthracycline doses surpass 200 mg/m2 due to high attributable risk.
  • Further research is needed to explore other risk factors and the long-term effects of anthracycline therapy.
Abstract

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