Multimodal echocardiographic parameters did not differ significantly from baseline, but global longitudinal strain correlated significantly with cumulative alkylating agent dose (p<0.01).
Cohort (n=39)
Do cumulative doses of chemotherapy correlate with early echocardiographic signs of cardiotoxicity in children with leukemia?
While mean echocardiographic parameters did not significantly change 1 year post-chemotherapy in children with leukemia, cumulative doses of specific agents correlated with changes in diastolic function (E') and global longitudinal strain, suggesting dose-dependent early subclinical cardiotoxicity.
p-value: p=<0.01
Cardiotoxicity remains one of the leading causes of morbidity and mortality in childhood cancer survivors. This study aimed to evaluate cardiotoxic side effects of chemotherapeutic regimens in a pediatric population, as revealed by assessment of baseline end-of-treatment and in follow-up after 1 year. A prospective study was conducted on 39 children, enrolled over a period of 5 years (2017-2022), diagnosed with leukemia and receiving chemotherapy regimens. A multimodal echocardiographic evaluation was done (two-dimensional echocardiography and M-mode, tissue doppler imaging (TDI) and 2D-speckle tracking (2DST) before the initiation of the cytostatic treatment, at the end of the treatment and 1 year after the treatment. Ultrasound-derived parameter values were compared between evaluations and correlated with cumulative doses of chemotherapeutic agents used. There were no significant differences in mean values for any of the imagistic parameters analyzed. However, a significant correlation was found between E’value percentage variation and cumulative dose of both anthracyclines and antimetabolics administered (p=0.03). Moreover, a significant linear regression correlation was found between alkylating agent dose and global longitudinal strain (GLS)(p0.01). Non-invasive cardiovascular imaging parameter values did not differ significantly from baseline in our study, but some of them seem to be dependent upon cumulative dose of cytostatic agents used. Further studies on larger populations and involving a longer follow-up period might provide more insight into cardiotoxicity of chemotherapy regimens.
Făgărășan et al. (Mon,) conducted a cohort in Leukemia (n=39). Multimodal echocardiographic evaluation vs. Baseline evaluation was evaluated on Changes in ultrasound-derived parameter values and correlation with cumulative chemotherapy doses (p=<0.01). Multimodal echocardiographic parameters did not differ significantly from baseline, but global longitudinal strain correlated significantly with cumulative alkylating agent dose (p<0.01).