TY - JOUR
T1 - Clinical heart failure in a cohort of children treated with anthracyclines
T2 - A long-term follow-up study
AU - van Dalen, Elvira C.
AU - van der Pal, Helena J.H.
AU - Kok, Wouter E.M.
AU - Caron, Huib N.
AU - Kremer, Leontien C.M.
N1 - Funding Information:
The authors thank M.C. Cardous-Ubbink and J.H. van der Lee for their statistical advice, R.C. Heinen for helping in identifying all eligible patients, F.G. Hakvoort-Cammel (of the Late Effects Outpatient Clinic (LATER), Sophia Children’s Hospital/Erasmus MC, Rotterdam) and D. Bresters (of the Late Effects Outpatient Clinic (KLEP) of the Leiden University Medical Center, Leiden) for the provision of additional and follow-up data on patients who went to other hospitals for their follow-up, and all general practitioners who returned the questionnaire. This study was supported by the Foundation of Paediatric Cancer Research (SKK), Amsterdam, the Netherlands, and the Jacques H de Jong Foundation, Nieuwegein, the Netherlands.
PY - 2006/12
Y1 - 2006/12
N2 - The cumulative incidence of anthracycline-induced clinical heart failure (A-CHF) in a large cohort of 830 children treated with a mean cumulative anthracycline dose of 288 mg/m2 (median 280 mg/m2; range 15-900 mg/m2) with a very long and complete follow-up after the start of anthracycline therapy (mean 8.5 years; median 7.1 years; range 0.01-28.4 years) was 2.5%. A cumulative anthracycline dose of 300 mg/m2 or more was the only independent risk factor (relative risk (RR) = 8). The estimated risk of A-CHF increased with time to 5.5% at 20 years after the start of anthracycline therapy; 9.8% if treated with 300 mg/m2 or more. In conclusion, 1 in every 10 children treated with a cumulative anthracycline dose of 300 mg/m2 or more will eventually develop A-CHF. This is an extremely high risk and it reinforces the need of re-evaluating the cumulative anthracycline dose used in different treatment protocols and to define strategies to prevent A-CHF which could be implemented in treatment protocols.
AB - The cumulative incidence of anthracycline-induced clinical heart failure (A-CHF) in a large cohort of 830 children treated with a mean cumulative anthracycline dose of 288 mg/m2 (median 280 mg/m2; range 15-900 mg/m2) with a very long and complete follow-up after the start of anthracycline therapy (mean 8.5 years; median 7.1 years; range 0.01-28.4 years) was 2.5%. A cumulative anthracycline dose of 300 mg/m2 or more was the only independent risk factor (relative risk (RR) = 8). The estimated risk of A-CHF increased with time to 5.5% at 20 years after the start of anthracycline therapy; 9.8% if treated with 300 mg/m2 or more. In conclusion, 1 in every 10 children treated with a cumulative anthracycline dose of 300 mg/m2 or more will eventually develop A-CHF. This is an extremely high risk and it reinforces the need of re-evaluating the cumulative anthracycline dose used in different treatment protocols and to define strategies to prevent A-CHF which could be implemented in treatment protocols.
KW - Anthracyclines
KW - Congestive heart failure
KW - Paediatric cancer
UR - https://www.scopus.com/pages/publications/33845328492
U2 - 10.1016/j.ejca.2006.08.005
DO - 10.1016/j.ejca.2006.08.005
M3 - Article
C2 - 16987655
AN - SCOPUS:33845328492
SN - 0959-8049
VL - 42
SP - 3191
EP - 3198
JO - European Journal of Cancer
JF - European Journal of Cancer
IS - 18
ER -