Late cardiotoxic effects of anthracycline chemotherapy in childhood malignancies.

ABSTRACT

OBJECTIVE: To determine the frequency of changes in left ventricular function in patients, at least 5 years after completion of anthracycline-therapy for childhood malignancy. METHODS: Echocardiographic examination was performed on 58 patients (36 males and 22 females) with mean age of 17.5+/-4.6 years (range 9-29 years, median 17.5 years). The control group was 58 healthy age and sex matched children. RESULTS: The age at the time of diagnosis and start of treatment ranged from 2 to 14 years with a median of 6 years. The time of follow-up was between 5 to 22 years with a median of 9 years. The cumulative dose of anthracycline was 30 to 557 mg/m2, median 128.5 mg/m2. All the patients were asymptomatic. Abnormal systolic and/or diastolic functions were found in 29 (50%) patients. We found a strong correlation between systolic and diastolic cardiac dysfunction and longer time of follow-up (P = 0.02 and p = 0.04), respectively, but not a relation to the cumulative dose, sex, and age at diagnosis. CONCLUSION: The data showed a relatively high incidence of subclinical cardiotoxicity in long-term survivors. The significance of this subclinical cardiotoxicity on the morbidity and mortality of patients should be followed in the future.