Key result
High-dose anthracyclines linked to ~15% lower VO2peak vs moderate doses in childhood cancer survivors.
Why the study?
Childhood cancer survivors may face a high risk of chronic diseases from cardiotoxic side effects, motivating analysis of therapy effects on vascular structure and function, biomarkers, and physical activity.
Does prior anthracycline-based cancer therapy impair vascular structure, cardiac biomarkers, or exercise capacity in asymptomatic childhood cancer survivors compared to healthy controls or across dose groups?
Observational (n=136)
No
Does prior anthracycline-based cancer therapy impair vascular structure, cardiac biomarkers, or exercise capacity in asymptomatic childhood cancer survivors compared to healthy controls or across dose groups?
In asymptomatic childhood cancer survivors, NT-proBNP and exercise capacity are useful early markers for anthracycline-induced cardiovascular dysfunction, whereas cIMT and troponin are not.
Exercise capacity may flag early anthracycline effects in asymptomatic survivors; extends dose-response observations but leaves causal links and practice change open.
Introduction: Childhood cancer survivors (CCS) might be at high risk of additional chronic diseases due to cardiotoxic side effects. The aim of this study was to analyze long-term side effects of cancer therapy on vascular structure/function, cardiac biomarkers and on physical activity. Methods: In total, 68 asymptomatic patients aged 16–30 years with childhood cancer (diagnosed 10.6 ± 3.9 years ago) were examined from 2015–2020. (Central) blood pressure and pulse wave velocity were registered via the oscillometric method, while carotid intima-media thickness (cIMT) was measured non-invasively by ultrasound. cIMT values of patients were compared to healthy controls (n = 68; aged 22.3 ± 3.5 years). Patients’ exercise capacity was recorded. The plasma N-terminal pro-brain natriuretic protein (NTproBNP) and troponin levels were measured as cardiac biomarkers. CCS were categorized in groups with low, moderate and high anthracyclines. Results: No differences were found in cIMT between patients and controls as well as between patients with various anthracycline dosage. Patients with high dose anthracyclines showed a significant lower performance versus patients with moderate dose anthracyclines (84.4% of predicted VO2peak; p = 0.017). A total of 11.6% of CCS had abnormal NTproBNP values which correlated with received anthracycline dosage (p = 0.024; r = 0.343). Conclusion: NTproBNP levels and exercise capacity might be early markers for cardiovascular dysfunction in CCS and should be included in a follow-up protocol, while cIMT and troponin seem not to be adequate parameters.
No takes yet. Share an insight, caveat, or question.
Reiner et al. (2022) conducted an observational in Childhood cancer survivors (n=136). High-dose anthracycline therapy vs. Moderate-dose anthracycline therapy was evaluated on Exercise capacity (% of predicted VO2peak) (p=0.017). Childhood cancer survivors exposed to high-dose anthracyclines had significantly lower exercise capacity compared to those receiving moderate doses (84.4% vs 99.6% of predicted VO2peak, p=0.017).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:
More on Cardio-oncologyMore from Journal of Clinical Medicine