Use of cardiac markers to assess the toxic effects of anthracyclines given to children with cancer: a systematic review

Bryant, J., Picot, J., Baxter, L., Levitt, G., Sullivan, I. and Clegg, A. (2007) Use of cardiac markers to assess the toxic effects of anthracyclines given to children with cancer: a systematic review. European Journal of Cancer, 43 (13), 1959-1966. (doi:10.1016/j.ejca.2007.06.012). (PMID:17689066)

Abstract

Aim: To evaluate the effectiveness of cardiac markers to quantify anthracycline-induced cardiotoxicity in children with cancer.

Methods: Systematic review using a priori methods.

Results: Seven studies, all with methodological limitations, were identified. One RCT suggests that cardiac troponin can be used to assess the effectiveness of the cardio-protective agent dexrazoxane. Cohort studies suggest that atrial natriuretic peptide and brain (B-type) natriuretic peptide are elevated in some subgroups of patients compared with healthy children; NT-pro-BNP levels are significantly elevated in children with cardiac dysfunction compared with those without; serum lipid peroxide is higher in children who have received doxorubicin compared with children not receiving doxorubicin; there are no differences in carnitine levels between children treated with doxorubicin and a healthy control group.

Conclusions: The limited evidence makes conclusions difficult. Research is needed to fill this important evidence gap and link short-term changes in cardiac markers to longer-term cardiac damage.

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Contributors

Author: J. Picot

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