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 journalArticle

38 Citations (Scopus)


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
Pages (from-to)103-112
Number of pages10
JournalCurrent Opinion in Cardiology
Issue number1
StatePublished - Jan 1 2014


Cardiotonic Agents
Second Primary Neoplasms
Hormone Replacement Therapy
Dosage Forms
Heart Transplantation
Angiotensin-Converting Enzyme Inhibitors
Growth Hormone
Survival Rate
Drug Therapy
Wounds and Injuries


  • anthracyclines
  • cardiotoxicity
  • childhood cancer

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Lipshultz, S. E., Karnik, R., Sambatakos, P., Franco, V. I., Ross, S. W., & Miller, T. L. (2014). Anthracycline-related cardiotoxicity in childhood cancer survivors. Current Opinion in Cardiology, 29(1), 103-112.

Anthracycline-related cardiotoxicity in childhood cancer survivors. / Lipshultz, Steven E; Karnik, Ruchika; Sambatakos, Peter; Franco, Vivian I.; Ross, Samuel W.; Miller, Tracie L.

In: Current Opinion in Cardiology, Vol. 29, No. 1, 01.01.2014, p. 103-112.

Research output: Contribution to journalArticle

Lipshultz, SE, Karnik, R, Sambatakos, P, Franco, VI, Ross, SW & Miller, TL 2014, 'Anthracycline-related cardiotoxicity in childhood cancer survivors', Current Opinion in Cardiology, vol. 29, no. 1, pp. 103-112.
Lipshultz SE, Karnik R, Sambatakos P, Franco VI, Ross SW, Miller TL. Anthracycline-related cardiotoxicity in childhood cancer survivors. Current Opinion in Cardiology. 2014 Jan 1;29(1):103-112.
Lipshultz, Steven E ; Karnik, Ruchika ; Sambatakos, Peter ; Franco, Vivian I. ; Ross, Samuel W. ; Miller, Tracie L. / Anthracycline-related cardiotoxicity in childhood cancer survivors. In: Current Opinion in Cardiology. 2014 ; Vol. 29, No. 1. pp. 103-112.
title = "Anthracycline-related cardiotoxicity in childhood cancer survivors",
abstract = "Lippincott Williams & Wilkins.",
keywords = "anthracyclines, cardiotoxicity, childhood cancer",
author = "Lipshultz, {Steven E} and Ruchika Karnik and Peter Sambatakos and Franco, {Vivian I.} and Ross, {Samuel W.} and Miller, {Tracie L}",
year = "2014",
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doi = "10.1097/HCO.0000000000000034",
language = "English",
volume = "29",
pages = "103--112",
journal = "Current Opinion in Cardiology",
issn = "0268-4705",
publisher = "Lippincott Williams and Wilkins",
number = "1",



T1 - Anthracycline-related cardiotoxicity in childhood cancer survivors

AU - Lipshultz, Steven E

AU - Karnik, Ruchika

AU - Sambatakos, Peter

AU - Franco, Vivian I.

AU - Ross, Samuel W.

AU - Miller, Tracie L

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Lippincott Williams & Wilkins.

AB - Lippincott Williams & Wilkins.

KW - anthracyclines

KW - cardiotoxicity

KW - childhood cancer

UR -

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U2 - 10.1097/HCO.0000000000000034

DO - 10.1097/HCO.0000000000000034

M3 - Article

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AN - SCOPUS:84890434161

VL - 29

SP - 103

EP - 112

JO - Current Opinion in Cardiology

JF - Current Opinion in Cardiology

SN - 0268-4705

IS - 1

ER -