Kingston Rodolfo Ureña-Wong
Asociación para evitar la ceguera en México, MéxicoTitle: Predictors of anthracycline-induced cardiotoxicity in a retro-protective cohort of children surviving cancer
Abstract
Introduction: Cardiotoxicity is an adverse reaction associated with the use of anthracyclines. Objective: To estimate the factors associated with the development of anthracycline cardiotoxicity in pediatric patients surviving cancer. Method: Retro-prolective cohort of children diagnosed with cancer and treated with anthracyclines. Baseline echocardiographic determination of ejection fraction (LVEF0) was carried out before the start of treatment and again at 12 months (LVEF1). Demographic characteristics and treatment were obtained from the medical record. A multiple logistic regression (MLR) model was constructed; LVEF1 < 50 % was the dependent variable, which was adjusted for the main confounding variables. Results: Sixty-five patients were included, out of which 36.9 % were females and 56.8 % had a solid tumor. LVEF0 was 74.79 ± 7.3 % and LVEF1, 67.96 ± 6.7 % (p = 0.001); 60 % developed cardiotoxicity. In the MLR, only a cumulative dose > 430 mg was associated with cardiotoxicity (p = 0.001). Conclusions: In Mexican children, an anthracycline cumulative dose > 430 mg should be avoided in order to prevent cardiotoxicity.
Biography
Lipshultz SE, Colan SD, Gelber RD, Pérez-Atayde AR, Sallan SE, Sanders SP. Late cardiac effects of doxorubicin therapy for acute lymphoblastic leukemia in childhood. Fajardo-Gutiérrez A, Rendón-Macías ME, Mejía-Aranguré JM. Epidemiología del cáncer en nin~os mexicanos. Steinherz LJ, Steinherz PG, Tan CT, Heller G, Murphy ML. Cardiac toxicity 4 to 20 years after completing anthracycline therapy. JAMA. 58a Asamblea Mundial de la Salud:Prevención y Control del Cáncer. Suiza:Organización Mundial de la Salud. Instituto Nacional de Estadística y Geografía. Conteo de Población y Vivienda 2010. México. Rivas-Ruiz R, Villasís-Keever M, Miranda-Novales G, Castelán-Martínez OD, Rivas-Contreras S. Outpatient treatment for people with cancer who develop a low-risk febrile neutropaenic event. Cochrane Database Syst Rev. Weiss RB. The anthracyclines: will we ever find a better doxorubicin?Semin Oncol. Mertens AC, Yasui Y, Neglia JP, Potter JD, Nesbit ME Jr, Ruccione K, Smithson WA, Robison LL. Late mortality experience in five-year survivors of childhood and adolescent cancer: The Childhood Cancer Survivor Study. Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, et al. Chronic health conditions in adult survivors of childhood cancer.
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