Anthracycline-induced cardiotoxicity: A review of pathophysiology, diagnosis, and treatment

Shashi Raj, Vivian I. Franco, Steven E. Lipshultz

Research output: Contribution to journalReview articlepeer-review

97 Scopus citations


Anthracyclines have been widely used in children and adults to treat hematologic malignancies, soft-tissue sarcomas, and solid tumors. However, anthracyclines come with both short- and long-term cardiotoxic effects, ranging from occult changes in myocardial structure and function to severe cardiomyopathy and heart failure that may result in cardiac transplantation or death. Here, we review the progress made over the past two decades in understanding the molecular and genetic basis of anthracycline-induced cardiotoxicity; detecting and monitoring myocardial dysfunction; using adjunct cardioprotectant therapies, such as dexrazoxane; and improving cardioprotection with agents such as liposomal and pegylated doxorubicin. Despite this increased understanding, preventing drug-induced cardiotoxicity while maintaining oncologic efficacy to achieve the highest quality of life over a lifespan remain cornerstones of successful anthracycline chemotherapy during childhood.

Original languageEnglish (US)
Article number315
JournalCurrent Treatment Options in Cardiovascular Medicine
Issue number6
StatePublished - Jun 2014


  • Anthracycline
  • Cardiomyopathy
  • Childhood cancer survivor
  • Dexrazoxane
  • Left ventricular dysfunction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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