CARDIAC FUNCTION IN CHILDHOOD CANCER SURVIVORS TREATED WITH ANTHRACYCLINES: THE ROLE OF ECHOCARDIOGRAPHIC AND ELECTROCARDIOGRAPHIC SCREENING

Purpose (a): Anthracyclines have been a mainstay in cancer treatment because of their proven effectiveness in many children with acute leukemia, but have a dose limiting toxicity on cardiac function, in particular cardiomyopathy and potential arrhythmias. This cardiotoxicity is correlated with age at treatment, total cumulative dose of anthracyclines administered, and delivery of radiation therapy to the mediastinum. Current Children’s Oncology Group (COG) treatment guidelines recommend that childhood cancer survivors who received anthracyclines be monitored for long-term cardiotoxic effects using echocardiograms (ECHO) and electrocardiograms (ECG). To date there has been little research on whether following COG guidelines prevent any morbidity or mortality in these cancer survivors. Methods (b): A retrospective chart review of the anthracycline treated survivors seen in the Cook Children’s Life After Cancer Program (LACP) who received cardiac screening ECHOs and ECGs between January 1, 2011, through June 30, 2013, was performed in order to examine the clinical utility of screening ECHOs and ECGs. Results (c): Initial results from this retrospective chart review study showed that most Acute Lymphoblastic Leukemia survivors displayed no signs of cardiotoxicity on ECHOs or ECGs. Only three subjects required further cardiac evaluation from the results of their cardiac screening. Of those three, only one subject was advised to undergo interventional therapy. Conclusions (d): Preliminary results from this study suggest that these survivors who show little change in their cardiac function could benefit from less frequent screening, which would result in less time away from school and/or work and prevent extra medical cost.