What question did this study set out to answer?

To evaluate late cardiac status and identify risk factors for cardiotoxicity in long-term survivors of pediatric cancers treated with anthracyclines.

September 25, 1991JAMA

Cardiac toxicity 4 to 20 years after completing anthracycline therapy

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Population

201 long-term survivors of pediatric malignancies who received chemotherapy, including anthracyclines, with…

Design

Cohort

Follow-up

4 to 20 years (median, 7 years)

Authors

LSLaurel J. SteinherzPediatrics and Genetics

Discussion

Member takes

Implication

Supports long-term echocardiographic surveillance in anthracycline-treated survivors; leaves open optimal intervals and preventive interventions.

Key Points

To evaluate late cardiac status and identify risk factors for cardiotoxicity in long-term survivors of pediatric cancers treated with anthracyclines.
Evaluated a consecutive cohort of 201 pediatric cancer survivors using echocardiography 4 to 20 years (median, 7 years) after anthracycline completion in a prospective and retrospective analysis.
Assessed risk factors including cumulative anthracycline dose (range, 200 to 1275 mg/m²; median, 450 mg/m²), mediastinal radiotherapy (n=51), age at treatment, and follow-up duration.
Abnormal systolic cardiac function on noninvasive testing occurred in 23% (47/201) of the overall cohort, correlating significantly with cumulative dose, follow-up duration, and mediastinal radiotherapy.
Cardiac abnormalities were detected in 38% (21/56) of patients followed for ≥10 years (median, 12 years) compared to 18% (26/145) followed for <10 years, reaching 63% among survivors followed for ≥10 years who received ≥500 mg/m².
Late clinical symptoms occurred in 9 of 201 patients (including heart failure and dysrhythmia) with 3 sudden deaths, and tissue analysis revealed myocardial fibrosis on biopsy and autopsy.

Structured PICO

Population

201 long-term survivors of pediatric malignancies who received chemotherapy, including anthracyclines (total dose 200 to 1275 mg/m2), with 51 patients having received mediastinal radiotherapy.

Intervention

Anthracycline therapy (total dose 200 to 1275 mg/m2, median 450 mg/m2)

Outcome

Overall incidence and severity of abnormal systolic cardiac function evaluated by echocardiogramsurrogate

Long-term survivors of pediatric malignancies treated with anthracyclines have a high incidence (23%) of late cardiac abnormalities, emphasizing the need for continued long-term echocardiographic surveillance.

Cite This Study

Laurel J. Steinherz (1991) studied this question.

synapsesocial.com/papers/6a970c35805b2d6b5dbb7378 https://doi.org/10.1001/jama.266.12.1672

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Implication

Supports long-term echocardiographic surveillance in anthracycline-treated survivors; leaves open optimal intervals and preventive interventions.

Cardiac toxicity 4 to 20 years after completing anthracycline therapy

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Cardiac toxicity 4 to 20 years after completing anthracycline therapy

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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