Cardiotoxicity and cardioprotection in childhood cancer.

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

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Children diagnosed with cancer are now living longer as a result of advances in treatment. However, some commonly used anticancer drugs, although effective in curing cancer, can also cause adverse late effects. The cardiotoxic effects of anthracycline chemotherapy, such as doxorubicin, and radiation can cause persistent and progressive cardiovascular damage, emphasizing a need for effective prevention and treatment to reduce or avoid cardiotoxicity. Examples of risk factors for cardiotoxicity in children include higher anthracycline cumulative dose, higher dose of radiation, younger age at diagnosis, female sex, trisomy 21 and black race. However, not all who are exposed to toxic treatments experience cardiotoxicity, suggesting the possibility of a genetic predisposition. Cardioprotective strategies under investigation include the use of dexrazoxane, which provides short- and long-term cardioprotection in children treated with doxorubicin without interfering with oncological efficacy, the use of less toxic anthracycline derivatives and nutritional supplements. Evidence-based monitoring and screening are needed to identify early signs of cardiotoxicity that have been validated as surrogates of subsequent clinically significant cardiovascular disease before the occurrence of cardiac damage, in patients who may be at higher risk.

Original languageEnglish
Pages (from-to)391-399
Number of pages9
JournalActa Haematologica
Volume132
Issue number3-4
DOIs
StatePublished - Jan 1 2014

Fingerprint

Anthracyclines
Poisons
Doxorubicin
Neoplasms
Dexrazoxane
Radiation
Genetic Predisposition to Disease
Down Syndrome
Cardiovascular Diseases
Therapeutics
Drug Therapy
Cardiotoxicity
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Hematology

Cite this

Lipshultz, S. E., Sambatakos, P., Maguire, M., Karnik, R., Ross, S. W., Franco, V. I., & Miller, T. L. (2014). Cardiotoxicity and cardioprotection in childhood cancer. Acta Haematologica, 132(3-4), 391-399. https://doi.org/10.1159/000360238

Cardiotoxicity and cardioprotection in childhood cancer. / Lipshultz, Steven E; Sambatakos, Peter; Maguire, Michael; Karnik, Ruchika; Ross, Samuel W.; Franco, Vivian I.; Miller, Tracie L.

In: Acta Haematologica, Vol. 132, No. 3-4, 01.01.2014, p. 391-399.

Research output: Contribution to journalArticle

Lipshultz, SE, Sambatakos, P, Maguire, M, Karnik, R, Ross, SW, Franco, VI & Miller, TL 2014, 'Cardiotoxicity and cardioprotection in childhood cancer.', Acta Haematologica, vol. 132, no. 3-4, pp. 391-399. https://doi.org/10.1159/000360238
Lipshultz SE, Sambatakos P, Maguire M, Karnik R, Ross SW, Franco VI et al. Cardiotoxicity and cardioprotection in childhood cancer. Acta Haematologica. 2014 Jan 1;132(3-4):391-399. https://doi.org/10.1159/000360238
Lipshultz, Steven E ; Sambatakos, Peter ; Maguire, Michael ; Karnik, Ruchika ; Ross, Samuel W. ; Franco, Vivian I. ; Miller, Tracie L. / Cardiotoxicity and cardioprotection in childhood cancer. In: Acta Haematologica. 2014 ; Vol. 132, No. 3-4. pp. 391-399.
@article{ef5b6b346b034da0ad79e399aa8ebdc9,
title = "Cardiotoxicity and cardioprotection in childhood cancer.",
abstract = "Children diagnosed with cancer are now living longer as a result of advances in treatment. However, some commonly used anticancer drugs, although effective in curing cancer, can also cause adverse late effects. The cardiotoxic effects of anthracycline chemotherapy, such as doxorubicin, and radiation can cause persistent and progressive cardiovascular damage, emphasizing a need for effective prevention and treatment to reduce or avoid cardiotoxicity. Examples of risk factors for cardiotoxicity in children include higher anthracycline cumulative dose, higher dose of radiation, younger age at diagnosis, female sex, trisomy 21 and black race. However, not all who are exposed to toxic treatments experience cardiotoxicity, suggesting the possibility of a genetic predisposition. Cardioprotective strategies under investigation include the use of dexrazoxane, which provides short- and long-term cardioprotection in children treated with doxorubicin without interfering with oncological efficacy, the use of less toxic anthracycline derivatives and nutritional supplements. Evidence-based monitoring and screening are needed to identify early signs of cardiotoxicity that have been validated as surrogates of subsequent clinically significant cardiovascular disease before the occurrence of cardiac damage, in patients who may be at higher risk.",
author = "Lipshultz, {Steven E} and Peter Sambatakos and Michael Maguire and Ruchika Karnik and Ross, {Samuel W.} and Franco, {Vivian I.} and Miller, {Tracie L}",
year = "2014",
month = "1",
day = "1",
doi = "10.1159/000360238",
language = "English",
volume = "132",
pages = "391--399",
journal = "Acta Haematologica",
issn = "0001-5792",
publisher = "S. Karger AG",
number = "3-4",

}

TY - JOUR

T1 - Cardiotoxicity and cardioprotection in childhood cancer.

AU - Lipshultz, Steven E

AU - Sambatakos, Peter

AU - Maguire, Michael

AU - Karnik, Ruchika

AU - Ross, Samuel W.

AU - Franco, Vivian I.

AU - Miller, Tracie L

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Children diagnosed with cancer are now living longer as a result of advances in treatment. However, some commonly used anticancer drugs, although effective in curing cancer, can also cause adverse late effects. The cardiotoxic effects of anthracycline chemotherapy, such as doxorubicin, and radiation can cause persistent and progressive cardiovascular damage, emphasizing a need for effective prevention and treatment to reduce or avoid cardiotoxicity. Examples of risk factors for cardiotoxicity in children include higher anthracycline cumulative dose, higher dose of radiation, younger age at diagnosis, female sex, trisomy 21 and black race. However, not all who are exposed to toxic treatments experience cardiotoxicity, suggesting the possibility of a genetic predisposition. Cardioprotective strategies under investigation include the use of dexrazoxane, which provides short- and long-term cardioprotection in children treated with doxorubicin without interfering with oncological efficacy, the use of less toxic anthracycline derivatives and nutritional supplements. Evidence-based monitoring and screening are needed to identify early signs of cardiotoxicity that have been validated as surrogates of subsequent clinically significant cardiovascular disease before the occurrence of cardiac damage, in patients who may be at higher risk.

AB - Children diagnosed with cancer are now living longer as a result of advances in treatment. However, some commonly used anticancer drugs, although effective in curing cancer, can also cause adverse late effects. The cardiotoxic effects of anthracycline chemotherapy, such as doxorubicin, and radiation can cause persistent and progressive cardiovascular damage, emphasizing a need for effective prevention and treatment to reduce or avoid cardiotoxicity. Examples of risk factors for cardiotoxicity in children include higher anthracycline cumulative dose, higher dose of radiation, younger age at diagnosis, female sex, trisomy 21 and black race. However, not all who are exposed to toxic treatments experience cardiotoxicity, suggesting the possibility of a genetic predisposition. Cardioprotective strategies under investigation include the use of dexrazoxane, which provides short- and long-term cardioprotection in children treated with doxorubicin without interfering with oncological efficacy, the use of less toxic anthracycline derivatives and nutritional supplements. Evidence-based monitoring and screening are needed to identify early signs of cardiotoxicity that have been validated as surrogates of subsequent clinically significant cardiovascular disease before the occurrence of cardiac damage, in patients who may be at higher risk.

UR - http://www.scopus.com/inward/record.url?scp=84908617799&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84908617799&partnerID=8YFLogxK

U2 - 10.1159/000360238

DO - 10.1159/000360238

M3 - Article

VL - 132

SP - 391

EP - 399

JO - Acta Haematologica

JF - Acta Haematologica

SN - 0001-5792

IS - 3-4

ER -