Division of Pediatric Clinical Research, Department of Pediatrics, University of Miami Miller School of Medicine, Medical Campus-BCRI-D820, 1580 NW 10th Avenue, 5th Floor, Miami, FL 33136, USA.
Cardiol Res Pract. 2011 Feb 10;2011:134679. doi: 10.4061/2011/134679.
Anthracyclines are commonly used to treat childhood leukemias and lymphomas, as well as other malignancies, leading to a growing population of long-term childhood cancer survivors. However, their use is limited by cardiotoxicity, increasing survivors' vulnerability to treatment-related complications that can markedly affect their quality of life. Survivors are more likely to suffer from heart failure, coronary artery disease, and cerebrovascular accidents compared to the general population. The specific mechanisms of anthracycline cardiotoxicity are complex and remain unclear. Hence, determining the factors that may increase susceptibility to cardiotoxicity is of great importance, as is monitoring patients during and after treatment. Additionally, treatment and prevention options, such as limiting cumulative dosage, liposomal anthracyclines, and dexrazoxane, continue to be explored. Here, we review the cardiovascular complications associated with the use of anthracyclines in treating malignancies in children and discuss methods for preventing, screening, and treating such complications in childhood cancer survivors.
蒽环类药物常用于治疗儿童白血病和淋巴瘤以及其他恶性肿瘤，由此产生了越来越多的长期儿童癌症幸存者。然而，其应用受到心脏毒性的限制，这增加了幸存者发生与治疗相关的并发症的脆弱性，这些并发症会显著影响他们的生活质量。与一般人群相比，幸存者更有可能患心力衰竭、冠状动脉疾病和脑血管意外。蒽环类药物心脏毒性的具体机制复杂且仍不清楚。因此，确定可能增加心脏毒性易感性的因素非常重要，在治疗期间和治疗后监测患者也很重要。此外，还在不断探索治疗和预防方案，如限制累积剂量、脂质体蒽环类药物和右雷佐生。在这里，我们回顾了蒽环类药物治疗儿童恶性肿瘤相关的心血管并发症，并讨论了预防、筛查和治疗儿童癌症幸存者此类并发症的方法。
