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Franco VI, Henkel JM, Miller TL, Lipshultz SE. Cardiovascular effects in childhood cancer survivors treated with anthracyclines. Cardiol Res Pract 2011; 2011:134679. [PMID: 21331374 PMCID: PMC3038566 DOI: 10.4061/2011/134679] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Accepted: 12/15/2010] [Indexed: 01/13/2023] Open
Abstract
Anthracyclines are commonly used to treat childhood leukemias and lymphomas, as well as other malignancies, leading to a growing population of long-term childhood cancer survivors. However, their use is limited by cardiotoxicity, increasing survivors' vulnerability to treatment-related complications that can markedly affect their quality of life. Survivors are more likely to suffer from heart failure, coronary artery disease, and cerebrovascular accidents compared to the general population. The specific mechanisms of anthracycline cardiotoxicity are complex and remain unclear. Hence, determining the factors that may increase susceptibility to cardiotoxicity is of great importance, as is monitoring patients during and after treatment. Additionally, treatment and prevention options, such as limiting cumulative dosage, liposomal anthracyclines, and dexrazoxane, continue to be explored. Here, we review the cardiovascular complications associated with the use of anthracyclines in treating malignancies in children and discuss methods for preventing, screening, and treating such complications in childhood cancer survivors.
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Affiliation(s)
- Vivian I. Franco
- Division of Pediatric Clinical Research, Department of Pediatrics, University of Miami Miller School of Medicine, Medical Campus-BCRI-D820, 1580 NW 10th Avenue, 5th Floor, Miami, FL 33136, USA
| | - Jacqueline M. Henkel
- Division of Pediatric Clinical Research, Department of Pediatrics, University of Miami Miller School of Medicine, Medical Campus-BCRI-D820, 1580 NW 10th Avenue, 5th Floor, Miami, FL 33136, USA
| | - Tracie L. Miller
- Division of Pediatric Clinical Research, Department of Pediatrics, University of Miami Miller School of Medicine, Medical Campus-BCRI-D820, 1580 NW 10th Avenue, 5th Floor, Miami, FL 33136, USA
- Holtz Children's Hospital of the University of Miami/Jackson Memorial Medical Center, Sylvester Comprehensive Cancer Center, Miami, FL 33136, USA
| | - Steven E. Lipshultz
- Division of Pediatric Clinical Research, Department of Pediatrics, University of Miami Miller School of Medicine, Medical Campus-BCRI-D820, 1580 NW 10th Avenue, 5th Floor, Miami, FL 33136, USA
- Holtz Children's Hospital of the University of Miami/Jackson Memorial Medical Center, Sylvester Comprehensive Cancer Center, Miami, FL 33136, USA
- Department of Pediatrics (D820), University of Miami Miller School of Medicine, P.O. Box 016820, Miami, FL 33101, USA
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