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February 1, 1998Journal of Clinical Oncology

Relationship between cumulative anthracycline dose and late cardiotoxicity in childhood acute lymphoblastic leukemia.

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Why the study?

Does cumulative anthracycline dose affect late cardiotoxicity (left ventricular dimension and fractional shortening) in survivors of childhood acute lymphoblastic leukemia?

Population

189 survivors of childhood acute lymphoblastic leukemia

Comparison

Anthracycline therapy at varying cumulative doses vs Lower cumulative anthracycline doses and a…

Design

Cohort

Follow-up

median 8.1 years (range, 2.0 to 23.4)

Key result

Cumulative anthracycline doses >300 mg/m2 in childhood leukemia survivors were associated with significantly depressed left ventricular fractional shortening (29.0% vs predicted 33.8%; P=0.0001).

Authors

KNKarsten NysomKHKirsten HolmSLStuart R. Lipsitz

Discussion

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Overview

May increase late LV dysfunction risk above 300 mg/m²; leaves open optimal dose thresholds and monitoring in survivors.

Study Design

Type

Cohort (n=189)

Multicenter

Yes

Structured PICO

Does cumulative anthracycline dose affect late cardiotoxicity (left ventricular dimension and fractional shortening) in survivors of childhood acute lymphoblastic leukemia?

P
Population
189 survivors of childhood acute lymphoblastic leukemia
I
Intervention
Anthracycline therapy at varying cumulative doses (0 to 550 mg/m2)
C
Comparator
Lower cumulative anthracycline doses and a control population (n=296)
O
Outcome
Left ventricular dimension and fractional shortening measured by echocardiogramsurrogate

Main Result

p-value: p=.0001

Late cardiotoxicity, indicated by depressed left ventricular fractional shortening and dilatation, is uncommon in childhood leukemia survivors when cumulative anthracycline doses are ≤300 mg/m2.

Cite This Study

Nysom et al. (1998) conducted a cohort in childhood acute lymphoblastic leukemia (n=189). Anthracycline therapy vs. Control population and lower dose groups was evaluated on Left ventricular dimension and fractional shortening (p=.0001). Cumulative anthracycline doses >300 mg/m2 in childhood leukemia survivors were associated with significantly depressed left ventricular fractional shortening (29.0% vs predicted 33.8%; P=0.0001).

synapsesocial.com/papers/6a12587b8edbaba0bf6710fdhttps://doi.org/10.1200/jco.1998.16.2.545
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