Use of cardiac markers to assess the toxic effects of anthracyclines given to children with cancer: a systematic review

Jackie Bryant, J Picot, L Baxter, G Levitt, I Sullivan, A Clegg

Research output: Contribution to journalReview articlepeer-review

Abstract

AIM: To evaluate the effectiveness of cardiac markers to quantify anthracycline-induced cardiotoxicity in children with cancer.

METHODS: Systematic review using a priori methods.

RESULTS: Seven studies, all with methodological limitations, were identified. One RCT suggests that cardiac troponin can be used to assess the effectiveness of the cardio-protective agent dexrazoxane. Cohort studies suggest that atrial natriuretic peptide and brain (B-type) natriuretic peptide are elevated in some subgroups of patients compared with healthy children; NT-pro-BNP levels are significantly elevated in children with cardiac dysfunction compared with those without; serum lipid peroxide is higher in children who have received doxorubicin compared with children not receiving doxorubicin; there are no differences in carnitine levels between children treated with doxorubicin and a healthy control group.

CONCLUSIONS: The limited evidence makes conclusions difficult. Research is needed to fill this important evidence gap and link short-term changes in cardiac markers to longer-term cardiac damage.

Original languageEnglish
Pages (from-to)1959-66
Number of pages8
JournalEuropean Journal Of Cancer Care
Volume43
Issue number13
DOIs
Publication statusPublished - Sep 2007

Keywords

  • Anthracyclines/adverse effects
  • Antibiotics, Antineoplastic/adverse effects
  • Biomarkers/metabolism
  • Child, Preschool
  • Cohort Studies
  • Heart/drug effects
  • Heart Diseases/chemically induced
  • Humans
  • Neoplasms/drug therapy
  • Randomized Controlled Trials as Topic
  • Survivors

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