Key result
Pediatric chemotherapy drugs, particularly anthracyclines, are associated with significant cardiotoxicity, which can be influenced by genetic variations and potentially mitigated by cardioprotective agents like dexrazoxane.
Why the study?
Pediatric chemotherapy can cause severe cardiotoxicity, and cardiac physiology and drug effects in children differ markedly from adults, necessitating a dedicated evaluation of cardiotoxic effects in the pediatric population.
This review emphasizes the importance of understanding, identifying, and managing the unique cardiotoxic effects of chemotherapy drugs in the pediatric population.
May warrant enhanced cardiac surveillance in pediatric anthracycline recipients; leaves open optimal genetic screening and dexrazoxane strategies pending trials.
Pediatric cancers are a common cause of childhood morbidity. As a result, chemotherapeutic regimens have been designed to target childhood cancers. These medications are necessary to treat pediatric cancers, however, oncology management options are accompanied by multiple negative and potentially fatal adverse effects. Although anthracyclines are the most commonly used chemotherapeutic agents associated with cardiotoxicity, we also explore other chemotherapeutic drugs used in children that can potentially affect the heart. Genetic variations resulting in single nucleotide polymorphism (SNP) have the propensity to modify the cardiotoxic effects of the chemotherapy drugs. The clinical presentation of the cardiac effects can vary from arrhythmias and heart failure to completely asymptomatic. A range of imaging studies and laboratory investigations can protect the heart from severe outcomes. The physiology of the heart and the effect of drugs in children vary vividly from adults; therefore, it is crucial to study the cardiotoxic effect of chemotherapy drugs in the pediatric population. This review highlights the potential contributing factors for cardiotoxicity in the pediatric population and discusses the identification and management options.
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Hitawala et al. (2021) conducted a review in Pediatric cancer and chemotherapy-induced cardiotoxicity. Chemotherapy drugs (Anthracyclines, Tyrosine kinase inhibitors, VEGF inhibitors) was evaluated. Pediatric chemotherapy drugs, particularly anthracyclines, are associated with significant cardiotoxicity, which can be influenced by genetic variations and potentially mitigated by cardioprotective agents like dexrazoxane.
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