Key result
Anthracycline therapy in childhood leukemia survivors was associated with subtle myocardial abnormalities, with concomitant alkylating agents significantly influencing left atrial volume (p=0.02).
Why the study?
Does anthracycline therapy cause late cardiac damage and abnormal myocardial function in long-term childhood leukemia survivors?
Observational (n=46)
Does anthracycline therapy cause late cardiac damage and abnormal myocardial function in long-term childhood leukemia survivors?
Answers are grounded in this paper and cite their sources.
Childhood leukemia survivors treated with anthracyclines exhibit subtle late myocardial abnormalities, primarily diastolic dysfunction indicated by prolonged IVRT, even in the absence of clinical symptoms.
Long-term leukemia survivors (46) underwent cardiac evaluation, including physical examination, ECG, exercise testing, and echocardiography. They were 2-17 years old at diagnosis and 5-23 years old after treatment. Thirty-four survivors received anthracyclines (AC) (mean 203 mg/m2), 12 of them had also alkylating agents (AA) and 12 had no AC. Exercise tolerance was bellow predicted values in 21 (48%) survivors and 21 survivors had ECG abnormalities, which were more frequent in those treated with AC. Concomitant AC with AA was correlated with prolonged isovolumic relaxation time (IVRT) and influenced significantly the volume of left atrium (p = .02). Sixteen (52%) survivors had IVRT > or = 90 ms. There were no significant differences in other parameters of diastolic or systolic function. Despite the lack of clinical symptoms in the survivors treated with lower doses of AC, subtile abnormalities in myocardial function were found, mainly manifest as abnormal diastolic function. Prolonged IVRT may be a sensitive indicator for early detection of AC cardiotoxicity.
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Prestor et al. (2000) conducted an observational in Acute lymphoblastic leukemia in childhood (n=46). Anthracyclines vs. No anthracyclines was evaluated on Cardiac abnormalities including exercise tolerance, ECG, and echocardiographic parameters (p=0.02). Anthracycline therapy in childhood leukemia survivors was associated with subtle myocardial abnormalities, with concomitant alkylating agents significantly influencing left atrial volume (p=0.02).
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