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Preventing Anthracycline Cardiotoxicity in Pediatric Survivors

Preventing Anthracycline Cardiotoxicity in Pediatric Survivors

NIAGARA-ON-THE-LAKE,
On-tario, Canada—The cardiotoxicity of anthracyclines can occur many years
after treatment for childhood cancer. Studies exploring methods to prevent
these effects were presented at the 7th International Conference for Long-Term
Complications of Treatment of Children and Adolescents for Cancer, hosted by
Ros-well Park Cancer Institute.

A group of researchers from the Gustave-Roussy Institute,
Villejuif, France, confirmed heart damage in a group of childhood cancer
survivors who received anthracycline therapy (abstract 9). Late cardiotoxicity
(15 years post-diagnosis) was found to be a health concern for 88 of 230 patients (38%), Dr.
F. de Vathaire said.

Using a Cox model, the researchers confirmed that cumulative
dose of anthracycline and the average radiation dose to the heart—but not sex
or age at treatment—were risk factors for cardiac impairment. The health risks
increased with increased drug dosages.

To counter these type of effects, researchers from the Great
Ormond Street Hospital for Children, London, UK, investigated a method of
lengthening anthracycline infusion time to possibly decrease cardiotoxicity
(abstract 11).

The team, led by Dr. Gill Levitt, found no differences in
cardiotoxicity between acute lymphoblastic leukemia (ALL) patients treated in a
standard manner (bolus dosing) and patients who received the drugs via a 6-hour
dosing schedule. Cardiac abnormalities appeared in 24% of both groups.

The patients received their cumulative 180 mg/m2
daunorubicin dose while participating in two different studies in England:
UKALL X (bolus dose) and UKALL XI (6-hour infusion). The cohort consisted of 40
ALL survivors from UKALL X and 71 ALL survivors from UKALL XI. Cardiac
performance in the cancer patients was compared with that in 100 normal
children.

US Enalapril Study

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