Review article
Anthracycline-related cardiotoxicity: risk factors and therapeutic options in childhood cancers
NADIA PUMA
; Division of Pediatric Oncology, Pol. A. Gemelli, Catholic University of Rome, Largo A. Gemelli 8, 00168 Rome, Italy
ANTONIO RUGGIERO
orcid.org/0000-0002-6052-3511
; Division of Pediatric Oncology, Pol. A. Gemelli, Catholic University of Rome, Largo A. Gemelli 8, 00168 Rome, Italy
VITA RIDOLA
; Division of Pediatric Oncology, Pol. A. Gemelli, Catholic University of Rome, Largo A. Gemelli 8, 00168 Rome, Italy
PALMA MAURIZI
; Division of Pediatric Oncology, Pol. A. Gemelli, Catholic University of Rome, Largo A. Gemelli 8, 00168 Rome, Italy
ILARIA LAZZARESCHI
; Division of Pediatric Oncology, Pol. A. Gemelli, Catholic University of Rome, Largo A. Gemelli 8, 00168 Rome, Italy
GIORGIO ATTINÀ
; Division of Pediatric Oncology, Pol. A. Gemelli, Catholic University of Rome, Largo A. Gemelli 8, 00168 Rome, Italy
STEFANO MASTRANGELO
; Division of Pediatric Oncology, Pol. A. Gemelli, Catholic University of Rome, Largo A. Gemelli 8, 00168 Rome, Italy
GABRIELLA DE ROSA
; Division of Pediatric Oncology, Pol. A. Gemelli, Catholic University of Rome, Largo A. Gemelli 8, 00168 Rome, Italy
RICCARDO RICCARDI
; Division of Pediatric Oncology, Pol. A. Gemelli, Catholic University of Rome, Largo A. Gemelli 8, 00168 Rome, Italy
Abstract
Anthracyclines play an important role in chemotherapeutic regimens for a wide spectrum of childhood tumors, but they can cause cytotoxic damage to cardiac cells, especially in combination with radiotherapy. Furthermore, cardiotoxicity increases with the cumulative dose and may lead to congestive heart failure and cardiomyopathy. Other factors, including age, pre-existing cardiac disease, length of follow-up, gender, route of administration, concomitant exposure to some chemotherapeutic drugs, trisomy 21 and black race, play a role in increasing the risk of cardiac dysfunction. The prevention of anthracycline-induced cardiotoxicity is mandatory as children are expected to survive for decades after being cured of their cancer. The purpose of this work is to point out the major risk factors of cardiotoxicity in children and to summarize some strategies to limit or prevent this complication and to treat the development of acute heart failure.
Keywords
anthracycline; cardiotoxicity; childhood cancer; risk factors; prevention; acute heart failure
Hrčak ID:
22524
URI
Publication date:
1.4.2008.
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