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Early-onset Cardiotoxicity assessment related to anthracycline in children with leukemia. A Prospective Study
Adriana Linares Ballesteros1,2, Roy Sanguino Lobo3, Juan Camilo Villada Valencia1
1Universidad Nacional de Colombia, Facultad de Medicina, Departamento de Pediatría, Bogotá, Colombia Universidad Nacional de Colombia Universidad Nacional de Colombia Facultad de Medicina Departamento de Pediatría Bogotá Colombia.
Background:
Acute leukemias are the most frequent malignancies in children. Advances in treatment have improved the overall survival to 80%. Almost 10% of children with cancer develop clinical cardiac toxicity. Total anthracycline cumulative dose is a risk factor for early-onset cardiotoxicity.
Objective:
To describe the incidence of early-onset cardiotoxicity in children with acute leukemia treated with chemotherapy.
Methods:
A prospective descriptive study of patients >1 y and <18 years diagnosed with acute leukemia. Assessed with electrocardiograma, echocardiography, and blood biomarkers at diagnosis and during the follow-up.
Results:
94 patients with acute lymphoblastic leukemia and 18 with acute myeloid leukemia were included. 20 patients (17.9%) developed early-onset cardiotoxicity. Statistically significant data was seen after anthracycline dose >150 mg/m2, between the first echocardiographic evaluation and posterior analyses in the left ventricular fraction ejection with Teicholz p 0.05, Simpson p 0.018 and GLS p 0.004. In this study, there was no relation between blood biomarkers and cardiotoxicity.
Conclusions:
Cancer therapeutic-related cardiac dysfunction is related to anthracycline cumulative dose. In this study, echocardiographic follow-up was useful to predict risk factors for early cardiac dysfunction.
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