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Anthracycline-related cardiotoxicity: risk factors and therapeutic options in childhood cancers

  • NADIA PUMA1
  • ANTONIO RUGGIERO1
  • VITA RIDOLA1
  • PALMA MAURIZI1
  • ILARIA LAZZARESCHI1
  • GIORGIO ATTINÀ1
  • STEFANO MASTRANGELO1
  • GABRIELLA DE ROSA1
  • RICCARDO RICCARDI1

1Division of Pediatric Oncology, Pol. A. Gemelli Catholic University of Rome

DOI: 10.22514/SV31.042008.4 Vol.3,Issue 1,April 2008 pp.30-34

Published: 01 April 2008

*Corresponding Author(s): ANTONIO RUGGIERO E-mail: ruggiero@rm.unicatt.it

Abstract

Anthracyclines play an important role in chemotherapeutic regimens for a wide spectrum of childhood tumors, but they can cause cytotoxic damage to cardiac cells, especially in combination with radiotherapy. Furthermore, cardiotoxicity increases with the cumulative dose and may lead to congestive heart failure and cardiomyopathy. Other factors, including age, pre-existing cardiac disease, length of follow-up, gender, route of administration, concomitant exposure to some chemotherapeutic drugs, trisomy 21 and black race, play a role in increasing the risk of cardiac dysfunction. The prevention of anthracycline-induced cardiotoxicity is mandatory as children are expected to survive for decades after being cured of their cancer. The purpose of this work is to point out the major risk factors of cardiotoxicity in children and to summarize some strategies to limit or prevent this complication and to treat the development of acute heart failure. 

Keywords

anthracycline, cardiotox-icity, childhood cancer, risk factors, prevention, acute heart failure

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NADIA PUMA,ANTONIO RUGGIERO,VITA RIDOLA,PALMA MAURIZI,ILARIA LAZZARESCHI,GIORGIO ATTINÀ,STEFANO MASTRANGELO,GABRIELLA DE ROSA,RICCARDO RICCARDI. Anthracycline-related cardiotoxicity: risk factors and therapeutic options in childhood cancers. Signa Vitae. 2008. 3(1);30-34.

References

1. Alderton PM, Gross J, Green MD. Comparative study of doxorubicin, mitoxantrone and epirubicin in combination with ICRF-187 (ADR-529) in a chronic cardiotoxicity animal model. Canc Res 1992;52:194-201.

2. Rossi F, Fillippelli W, Russo S, Fillippellie A, Berrino L. Cardiotoxicity of doxorubicin: effects of drugs inhibiting the release of vasoactive substances. Pharm Tox 1994;75:99-107.

3. Vasquez-Vivar J, Martasek P, Hogg N, Masters BS, Pritchard KA Jr, Kalyanaraman B.

Endothelial nitric oxide synthase-dependent superoxide generation from adriamycin.

Biochem 1997;36:11293-97.

4. Rajagopalan S, Politi PM, Sinha BK, Myers CE. Adriamycin induced free radical formation in the perfused rat heart: implications for cardio-toxicity. Cancer Res 1988;48:4766-9.

5. Doroshow JH, Locker GY, Myers, CE. Enzymatic defenses of the mouse heart against reactive oxygen metabolites. J Clin Invest 1980;65:128-35.

6. Myers CE, McGuire WP, Liss RH, Ifrim I, Grotzinger K, Young RC. Adriamycin: the role of lipid peroxidation in cardiac toxicity and tumour responce. Science 1977;197:165-8.

7. Krischer JP, Epstein S, Cuthbertson DD, Goorin AM, Epstein ML, Lipshultz SE. Clinical cardiotoxicity following anthracycline treatment for childhood cancer: the Paediatric Oncology Group Experience. J Clin Oncol 1997;15:544-52.

8. Kremer LC, Van der Pal HJ, Offringa M, Van Dalen EC, Voute PA. Frequency and risk factors of subclinical cardiotoxicity after anthracycline therapy in children: a systematic review. Ann Oncol 2002;13:819-29.

9. Kremer LC, van Dalen EC, Offringa M, Voute PA. Frequency and risk factors of anthracycline-induced clinical heart failure in children: a systematic review. Ann Oncol 2002;13:503-12.

10. Kremer LC, Caron HM. Anthracycline cardiotoxicity in children. N Engl J Med 2004; 351:120-1.

11. Green DM, Grigoriev YA, Nan B, Takashima JR, Norkool PA, D’Angio GJ, et al, editors. Congestive heart failure after treatment for Wilms’ tumour: a report from National Wilms’ Tumour Study Group. J Clin Oncol 2001;19:1926-34.

12. Mertens AC, Yasui Y, Neglia JP, Potter JD, Nesbit ME Jr, Ruccione K, et al, editors. Late mortality experience in five-year survivors of child-hood and adolecent cancer: the Childhood Cancer Survivor Study. J Clin Oncol 2001;19:3163-72.

13. Lipshultz SE, Colan SD, Gelber RD, Perez-Atayde AR, Sallan SE, Sanders SP. Late cardiac effects of doxorubicin therapy for acute lym-phoblastic leukaemia in childhood. N Engl J Med 1991;324:808-15.

14. Von Hoff DD, Layard MW, Basa P, Davis HL Jr, Von Hoff AL, Rozencweig M, et al, editors. Risk factors for doxorubicin-induced congestive heart failure. Ann Intern Med 1979;91:710-7.

15. Pein F, Sakiroglu O, Dahan M, Lebidois J, Merlet P, Shamsaldin A, et al, editors. Cardiac abnormalities 15 years and more after adryamicin therapy in 229 childhood survivors of a solid tumour at the Institute Gustave Roussy. Brit J Cancer 2004;91:37-44.

16. Lipshultz SE, Lipsitz SR, Mone SM, Goorin AM, Sallan SE, Sanders SP, et al, editors. Female sex and higher drug dose as risk factors for late cardiotoxic effects of doxorubicin therapy for childhood cancer. N Engl J Med 1995;332:1738-43.

17. Lipshultz SE, Sallan SE. Cardiovascular abnormalities in long-term survivors of childhood malignancy. J Clin Oncol 1993;11:1199-203.

18. Yeung ST, Yoong C, Spink J, Galbraith A, Smith PJ. Functional myocardial impairment in children treated with anthracyclines for cancer. Lancet 1991;337:816-8.

19. Steinherz LJ, Steinherz PG, Tan CT, Heller G, Murphy ML. Cardiac toxicity 4 to 20 years after completing anthracycline therapy. JAMA 1991;266:1672-7.

20. Larsen RL, Jakacki RI, Vetter VL, Meadows AT, Silber JH, Barber G. Electrocardiographic changes and arrhythmias after cancer therapy in children and young adults. Am J Cardiol 1992;70:73-7.

21. Leandro J, Dyck J, Poppe D, Shore R, Airhart C, Greenberg M, et al, editors. Cardiac dysfunction late after cardiotoxic therapy for childhood cancer. Am J Cardiol 1994;74:1152-6.

22. Sorensen K, Levitt G, Sebag-Montefiore D, Bull C, Sullivan I. Cardiac function in Wilms’ tumour survivors. J Clin Oncol 1995;13:1546-56.

23. De Wolf D, Suys B, Maurus R, Benoit Y, Verhaaren H, Matthijs D, et al, editors. Dobutamine stress echocardiography in the evaluation of late anthracycline cardiotoxicity in childhood cancer survivors. Pediatr Res 1996;39:504-12.

24. Lipshultz SE, Colan SD. The use of echocardiography and Holter monitoring in the assessment of anthracycline-treated patients. In: Bricker JT, Green DM, DAngeo G, editors. Long Term Complications of Treatment of Children and Adolescents for Cancer. Philadelphia (PA): Wiley-Liss; 1993. pp. 45-62.

25. Adams MJ, Lipshultz SE. Pathophysiology of anthracyclines- and radiation-associated cardioyopathies: implications for screening and prevention. Pediatr Blood Cancer 2005;44:600-6.

26. Bristow MR, Thompson PD, Martin RP. Early anthracycline cardiotoxicity. Am J Med 1978;65:823-32.

27. Ross RD, Daniels SR, Schwartz DC, Hannon DW, Shukla R, Kaplan S. Plasma norepinephrine levels in infants and children with congestive heart failure. Am J Cardiol 1987;59:911-4.

28. Bossaert L, Van Hoeyweghen R. Bystander cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest. The Cerebral Resuscita-tion Study Group. Resuscitation 1989;17 Suppl:S55- 69; discussion S199-206.

29. Nichol G, Stiell IG, Laupacis A, Pham B, De Maio VJ, Wells GA. A cumulative meta-analysis of the effectiveness of defibrillator-capable emergency medical services for victims of out-of-hospital cardiac arrest. Ann Emerg Med 1999;34:517-25.

30. Landier W, Bhatia S, Eshelman DA, Forte KJ, Sweeney T, Hester AL, et al, editors. Development of risk-based guidelines for paediatric cancer survivors: the Children‘s Oncology Group Long-Term Follow-Up Guidelines from the Children‘s Oncology Group Late Effects Committee and Nursing Discipline. J Clin Oncol 2004;22:4979-90.

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