July 4, 2025Molecular and Cellular PediatricsOpen Access

A systematic review of long-term cardiotoxic effects of treatment in survivors of childhood acute lymphoblastic leukemia

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Why the study?

With 5-year survival rates exceeding 90% for childhood acute lymphoblastic leukemia, there is a pressing necessity to investigate the enduring cardiotoxic impacts of childhood cancer treatments.

Does anthracycline chemotherapy increase long-term cardiotoxic effects (diastolic dysfunction and congestive heart failure) in survivors of childhood acute lymphoblastic leukemia compared to healthy controls?

Population

Survivors of childhood ALL diagnosed at age < 21 years in remission

Comparison

Childhood ALL survivors treated with anthracyclines vs healthy control populations

Design

Systematic literature review

Authors

PJPaige JohnsonJohnson Matthey (United States)DBDonald BeamCook Children's Medical Center

Discussion

Member takes

Implication

Childhood ALL survivors need lifelong cardiac monitoring; supports refined risk stratification in survivorship guidelines.

Structured PICO

Population

2,209 survivors of childhood acute lymphoblastic leukemia (ALL) diagnosed at <21 years old, >5 years post-diagnosis and/or >120 weeks post-consolidation therapy, and in remission, pooled from 7 studies, compared to 8,885 healthy matched controls.

Intervention

Anthracycline chemotherapy (various agents and cumulative doses, e.g., mean 120 to >250 mg/m2 isotoxic doxorubicin equivalents), with or without radiation therapy and hematopoietic stem cell transplantation.

Comparator

Healthy control populations (siblings or healthy volunteers matched for age, sex, body weight, body surface area, and/or geography).

Outcome

Long-term cardiotoxic effects, specifically diastolic dysfunction and congestive heart failure (CHF).

Childhood ALL survivors treated with anthracyclines require regular monitoring for subclinical diastolic dysfunction and heart failure, especially females, those diagnosed at a younger age, and those receiving higher cumulative doses.

Limitations

Inclusion of patients who died of other causes in retrospective data
Sex imbalance in sibling control groups
Higher proportion of smokers in the ALL survivor group in some studies
Significant differences in height and body weight between survivors and controls
Use of different coefficients to convert various anthracyclines to an isotoxic cumulative dose of doxorubicin
Confounding from different inclusion criteria and concomitant treatments like radiation and hematopoietic stem cell transplantation

Cite This Study

Johnson et al. (2025) studied this question.

synapsesocial.com/papers/6a7cb71658d1f2c7e4c898e5 https://doi.org/10.1186/s40348-025-00196-y

View Full Paper

Ask AI

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A systematic review of long-term cardiotoxic effects of treatment in survivors of childhood acute lymphoblastic leukemia

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

A systematic review of long-term cardiotoxic effects of treatment in survivors of childhood acute lymphoblastic leukemia

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider