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.
- Anthracyclines/adverse effects
- Antibiotics, Antineoplastic/adverse effects
- Child, Preschool
- Cohort Studies
- Heart/drug effects
- Heart Diseases/chemically induced
- Neoplasms/drug therapy
- Randomized Controlled Trials as Topic