Late anthracycline cardiotoxicity in patients treated for childhood acute lymphoblastic leukemia

Introduction: advances in the treatment of childhood acute lymphoblastic leukemia give a greater life expectancy for these patients. As the number of survivors increase, more long-term adverse effects are detected. Among the most frequent adverse effects stands late anthracycline cardiotoxicity (dox...

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Main Authors: Tamara Cedré Hernández, Liliana Martínez Cárdenas, Marta Beatriz García Caraballoso, Alejandro González Díaz, Guillermo González Ojeda, Alina Castillo Villocht
Format: Article
Language:Spanish
Published: Editorial Ciencias Médicas 2013-10-01
Series:Acta Médica del Centro
Subjects:
Online Access:http://www.revactamedicacentro.sld.cu/index.php/amc/article/view/4
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author Tamara Cedré Hernández
Liliana Martínez Cárdenas
Marta Beatriz García Caraballoso
Alejandro González Díaz
Guillermo González Ojeda
Alina Castillo Villocht
author_facet Tamara Cedré Hernández
Liliana Martínez Cárdenas
Marta Beatriz García Caraballoso
Alejandro González Díaz
Guillermo González Ojeda
Alina Castillo Villocht
author_sort Tamara Cedré Hernández
collection DOAJ
description Introduction: advances in the treatment of childhood acute lymphoblastic leukemia give a greater life expectancy for these patients. As the number of survivors increase, more long-term adverse effects are detected. Among the most frequent adverse effects stands late anthracycline cardiotoxicity (doxorubicin and daunorubicin), drugs widely used in almost all chemotherapy regimens, but which are related to cardiovascular damage. Objective: To describe the major late cardiovascular changes which are secondary to the use of chemotherapy for acute lymphoblastic leukemia diagnosed in childhood. Material and methods: A descriptive, longitudinal and retrospective study was conducted with 82 patients diagnosed with acute lymphoblastic leukemia, aged between zero and 15 years of age in the Oncohematology Department of the José Luis Miranda Pediatric University Hospital of Villa Clara from 1969 and 2009, who completed the planned treatment and were followed up in consultation from the moment of stopping treatment until May 2012. The patients who died before the study, those who received no treatment with anthracyclines and those who did not cooperate with the investigation were excluded. The cumulative dose of anthracyclines received and the time elapsed between the administration of the last dose and the beginning of the study was estimated in all patients. All patients were assessed by physical examination, electrocardiogram and echocardiogram. To assess systolic function, the left ventricular ejection fraction and the shortening fraction were measured; and for diastolic function, the E and A waves and the E/A relationship were measured. Results: Subclinical late cardiotoxicity predominated in patients treated with anthracyclines, which affected both sexes equally, with no significant differences concerning the age at diagnosis, or cumulative doses received. More cases affected appeared with increasing follow-up time.
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spelling doaj.art-d4e39febb9464d0a9bf971d9b474c8ad2022-12-22T03:26:42ZspaEditorial Ciencias MédicasActa Médica del Centro2709-79272013-10-017323284Late anthracycline cardiotoxicity in patients treated for childhood acute lymphoblastic leukemiaTamara Cedré Hernández0Liliana Martínez Cárdenas1Marta Beatriz García Caraballoso2Alejandro González Díaz3Guillermo González Ojeda4Alina Castillo Villocht5Hospital Pediátrico “José Luis Miranda”, Santa Clara, Villa ClaraHospital Pediátrico “José Luis Miranda”, Santa Clara, Villa ClaraHospital Pediátrico “José Luis Miranda”, Santa Clara, Villa ClaraCardiocentro “Ernesto Che Guevara”, Santa ClaraHospital Pediátrico “José Luis Miranda”, Santa Clara, Villa ClaraCardiocentro “Ernesto Che Guevara”, Santa ClaraIntroduction: advances in the treatment of childhood acute lymphoblastic leukemia give a greater life expectancy for these patients. As the number of survivors increase, more long-term adverse effects are detected. Among the most frequent adverse effects stands late anthracycline cardiotoxicity (doxorubicin and daunorubicin), drugs widely used in almost all chemotherapy regimens, but which are related to cardiovascular damage. Objective: To describe the major late cardiovascular changes which are secondary to the use of chemotherapy for acute lymphoblastic leukemia diagnosed in childhood. Material and methods: A descriptive, longitudinal and retrospective study was conducted with 82 patients diagnosed with acute lymphoblastic leukemia, aged between zero and 15 years of age in the Oncohematology Department of the José Luis Miranda Pediatric University Hospital of Villa Clara from 1969 and 2009, who completed the planned treatment and were followed up in consultation from the moment of stopping treatment until May 2012. The patients who died before the study, those who received no treatment with anthracyclines and those who did not cooperate with the investigation were excluded. The cumulative dose of anthracyclines received and the time elapsed between the administration of the last dose and the beginning of the study was estimated in all patients. All patients were assessed by physical examination, electrocardiogram and echocardiogram. To assess systolic function, the left ventricular ejection fraction and the shortening fraction were measured; and for diastolic function, the E and A waves and the E/A relationship were measured. Results: Subclinical late cardiotoxicity predominated in patients treated with anthracyclines, which affected both sexes equally, with no significant differences concerning the age at diagnosis, or cumulative doses received. More cases affected appeared with increasing follow-up time.http://www.revactamedicacentro.sld.cu/index.php/amc/article/view/4cardiotoxinasantraciclinasleucemia-linfoma linfoblástico de células precursorasniño
spellingShingle Tamara Cedré Hernández
Liliana Martínez Cárdenas
Marta Beatriz García Caraballoso
Alejandro González Díaz
Guillermo González Ojeda
Alina Castillo Villocht
Late anthracycline cardiotoxicity in patients treated for childhood acute lymphoblastic leukemia
Acta Médica del Centro
cardiotoxinas
antraciclinas
leucemia-linfoma linfoblástico de células precursoras
niño
title Late anthracycline cardiotoxicity in patients treated for childhood acute lymphoblastic leukemia
title_full Late anthracycline cardiotoxicity in patients treated for childhood acute lymphoblastic leukemia
title_fullStr Late anthracycline cardiotoxicity in patients treated for childhood acute lymphoblastic leukemia
title_full_unstemmed Late anthracycline cardiotoxicity in patients treated for childhood acute lymphoblastic leukemia
title_short Late anthracycline cardiotoxicity in patients treated for childhood acute lymphoblastic leukemia
title_sort late anthracycline cardiotoxicity in patients treated for childhood acute lymphoblastic leukemia
topic cardiotoxinas
antraciclinas
leucemia-linfoma linfoblástico de células precursoras
niño
url http://www.revactamedicacentro.sld.cu/index.php/amc/article/view/4
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