Anthracycline-related cardiotoxicity in childhood cancer survivors

Steven E. Lipshultz, Ruchika Karnik, Peter Sambatakos, Vivian I. Franco, Samuel W. Ross, Tracie L. Miller

Research output: Contribution to journalReview articlepeer-review

50 Scopus citations


PURPOSE OF REVIEW: Anthracyclines have markedly improved the survival rates of children with cancer. However, anthracycline-related cardiotoxicity is also well recognized and can compromise the long-term outcome in some patients. The challenge remains of how to balance the chemotherapeutic effects of anthracycline treatment with its potentially serious cardiovascular complications. Here, we review the pathophysiology, risk factors, clinical manifestations, prevention, and treatment of anthracycline-related cardiotoxicity. RECENT FINDINGS: Some risk factors and biomarkers associated with an increased probability of anthracycline-related cardiotoxicity have been identified. Modifying the structural forms and dosages of anthracyclines and coadministering cardioprotective agents may prevent some of these cardiotoxic effects. Cardiovascular complications have also been treated with angiotensin-converting enzyme inhibitors, β-blockers, and growth hormone replacement therapy. Cardiac transplantation remains the treatment of last resort. SUMMARY: Despite major advances in cancer treatment, anthracycline-related cardiotoxicity remains a major cause of morbidity and mortality in survivors of childhood cancer. Promising areas of research include: use of biomarkers for early recognition of cardiac injury in children receiving chemotherapy, development and application of cardioprotective agents for prevention of cardiotoxicity, and advancements in therapies for cardiac dysfunction in children after anthracycline treatment.

Original languageEnglish (US)
Pages (from-to)103-112
Number of pages10
JournalCurrent opinion in cardiology
Issue number1
StatePublished - Jan 1 2014


  • anthracyclines
  • cardiotoxicity
  • childhood cancer

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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