Childhood cancer: attention to heart risk in survivors

For children who have survived cancer, not all chemotherapies are the same in terms of long-term heart risk.

In long-term survivors of childhood cancer, cardiovascular disease is one of the leading causes of early non-cancer death. In a new study, published in JAMA Oncology, the researchers compared four chemotherapy drugs with the development of cardiomyopathy years after treatment.

Screening for cardiovascular complications in survivors

Cardiomyopathy is a rare heart muscle disease that affects less than one in 2,000 people in Europe. "Exposure to anthracycline-based chemotherapy, such as doxorubicin, has long been associated with an increased risk of cardiovascular disease in long-term childhood cancer survivors," said Gregory Aune, author of the study, elsewhere pediatrician / oncologist at UT Health San Antonio.

"Previously, it was assumed that exposure to any member of the anthracycline class had the same risk of late cardiovascular complications." By studying the results of over 28,000 long-term survivors in the United States and Europe, this research indicates Exposure to different anthracyclines leads to long-term variable cardiovascular risk.In the future, it will be important to consider these differences when screening for cardiovascular complications in long-term survivors and developing modern therapies. ", he explains.
The study also found that daunorubicin was associated with a decreased risk of cardiomyopathy compared with doxorubicin. Mitoxantrone, another chemotherapy, seemed to present a higher risk of long-term cardiomyopathy than expected.

Minimize late side effects of treatment

"In recent decades, we have focused on developing more effective drug combinations to cure patients," said Gail Tomlinson, a pediatric professor and director of a pediatric hematology-oncology department. "This has allowed us to dramatically increase the survival rate for most types of childhood cancer.While so many survivors are there, it is imperative to develop protocols based on the goal of minimizing late side effects. treatments, "she explains.
Each year, approximately 2,550 new cases of cancer are diagnosed in children and adolescents. It is estimated that one in 440 children will be diagnosed with cancer by the age of 15. The survival of children and adolescents affected has improved significantly and now exceeds 80%, all cancers combined. In children (under 15 years), the main localizations are leukemias (29% of cases, 80% of acute lymphoblastic leukemias), central nervous system (CNS) tumors (25%), and lymphomas (10%). %).

Video: Childhood Cancer Survivorship. Cit of Hope (December 2019).