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ISSN 1995-9494 (Electronic)
Revista del Hospital Clínico Quirúrgico "Arnaldo Milián Castro"

2013, Number 3

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Acta Med Cent 2013; 7 (3)

Late anthracycline cardiotoxicity in patients treated for childhood acute lymphoblastic leukemia

Cedré HT, Martínez CL, García CMB, González DA, González OG, Castillo VA

Language: Spanish
References: 16
Page:
PDF size: 160.75 Kb.


ABSTRACT

Introduction: advances in the treatment of childhood acute lymphoblastic leukemia give a greater life expectancy for these patients. As the number of survivors increase, more long-term adverse effects are detected. Among the most frequent adverse effects stands late anthracycline cardiotoxicity (doxorubicin and daunorubicin), drugs widely used in almost all chemotherapy regimens, but which are related to cardiovascular damage. Objective: To describe the major late cardiovascular changes which are secondary to the use of chemotherapy for acute lymphoblastic leukemia diagnosed in childhood. Material and methods: A descriptive, longitudinal and retrospective study was conducted with 82 patients diagnosed with acute lymphoblastic leukemia, aged between zero and 15 years of age in the Oncohematology Department of the José Luis Miranda Pediatric University Hospital of Villa Clara from 1969 and 2009, who completed the planned treatment and were followed up in consultation from the moment of stopping treatment until May 2012. The patients who died before the study, those who received no treatment with anthracyclines and those who did not cooperate with the investigation were excluded. The cumulative dose of anthracyclines received and the time elapsed between the administration of the last dose and the beginning of the study was estimated in all patients. All patients were assessed by physical examination, electrocardiogram and echocardiogram. To assess systolic function, the left ventricular ejection fraction and the shortening fraction were measured; and for diastolic function, the E and A waves and the E/A relationship were measured. Results: Subclinical late cardiotoxicity predominated in patients treated with anthracyclines, which affected both sexes equally, with no significant differences concerning the age at diagnosis, or cumulative doses received. More cases affected appeared with increasing follow-up time.


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