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 - Sept 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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