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儿童蒽环类药物治疗后的妊娠与心肌病

Pregnancy and Cardiomyopathy After Anthracyclines in Childhood.

作者信息

Thompson Kara Annette

机构信息

Department of Cardiology, University of Texas MD Anderson Cancer Center, Houston, TX, United States.

出版信息

Front Cardiovasc Med. 2018 Mar 26;5:14. doi: 10.3389/fcvm.2018.00014. eCollection 2018.

Abstract

With advances in cancer therapy, there has been a remarkable increase in survival in children diagnosed with malignancies. Many of these children are treated with anthracyclines which are well known to cause cardiotoxicity. As more childhood cancer survivors reach childbearing age, many will choose to become pregnant. At this time, the factors associated with development of cardiomyopathy after anthracycline treatment are not clearly identified. It is possible that cardiac stress could predispose to cardiac deterioration in a patient with reduced functional reserve from prior anthracycline exposure. Pregnancy is one form of cardiovascular stress. The cardiac outcomes of pregnancy in childhood cancer survivors must be considered. In view of limited data, guidelines for pregnancy planning, management, and monitoring after cardiotoxic cancer therapy have not been established. This review summarizes the limited data available on the topic of pregnancy after anthracyclines in childhood.

摘要

随着癌症治疗的进展,被诊断为恶性肿瘤的儿童的生存率显著提高。这些儿童中有许多接受了蒽环类药物治疗,众所周知,蒽环类药物会导致心脏毒性。随着越来越多的儿童癌症幸存者达到生育年龄,许多人会选择怀孕。此时,与蒽环类药物治疗后心肌病发生相关的因素尚未明确。对于先前接触过蒽环类药物而功能储备降低的患者,心脏应激可能会使其易发生心脏功能恶化。怀孕是心血管应激的一种形式。必须考虑儿童癌症幸存者怀孕后的心脏结局。鉴于数据有限,尚未制定心脏毒性癌症治疗后怀孕计划、管理和监测的指南。本综述总结了关于儿童蒽环类药物治疗后怀孕这一主题的有限可用数据。

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