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Cardio-Oncology in Childhood: State of the Art

  • Cardio-oncology (JN Upshaw, Section Editor)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Cardio-oncology is an increasingly important field of cardiology that focuses on the detection, monitoring, and treatment of cardiovascular disease (CVD) occurring during and after oncological treatments. The survival rate for childhood cancer patients has dramatically increased thanks to new treatment protocols and cardiovascular (CV) sequelae represent the third most frequent cause of mortality in surviving patients. This study aims to provide a complete and updated review of all the main aspects of cardio-oncology in childhood and to highlight the critical issues.

Recent Findings

The problem of CV complications in childhood cancer survivors raises the need to make an early diagnosis of cardiotoxicity by the new imaging and laboratory techniques in order to intervene promptly and to implement pharmacological strategies and lifestyle changes to reduce or even to prevent cardiac injury. Furthermore, a stratification of CV risk, also including new predisposing factors such as the presence of some genetic mutations, is of paramount importance before undertaking oncological treatments. Besides, a systematic and personalized planning of long-term follow-up is fundamental to ensure a transition from pediatric to adult hospital and to avoid missed or late diagnosis of cardiomyopathy.

Summary

We reviewed the main risk factors for cardiotoxicity in children, both traditional and emerging ones: the mechanisms of toxicity of both old and new antineoplastic therapies, the techniques for detecting cardiac damage, and the current evidence regarding pharmacological cardioprotection. At the end, we focused our attention on the existing guidelines and strategies about the long-term follow-up of childhood cancer survivors.

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Authors and Affiliations

  1. Pediatric Cardiology Unit, Meyer Children’s Hospital, Viale G. Pieraccini 24, Florence, Italy

    Elena Bennati, Francesca Girolami, Gaia Spaziani, Giovanni Battista Calabri & Silvia Favilli

  2. Department of Pediatric Hematology-Oncology, Meyer Children’s Hospital, Viale G. Pieraccini 24, Florence, Italy

    Claudio Favre & Angela Tamburini

  3. Cardiology Unit, Mauriziano Umberto I Hospital, Corso Turati 62, Turin, Italy

    Iris Parrini

  4. Department of Cardiology, Grande Ospedale Metropolitano, Azienda Ospedaliera Bianchi Melacrino Morelli, Reggio Calabria, Italy

    Fabiana Lucà

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  1. Elena Bennati
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Bennati, E., Girolami, F., Spaziani, G. et al. Cardio-Oncology in Childhood: State of the Art. Curr Oncol Rep 24, 1765–1777 (2022). https://doi.org/10.1007/s11912-022-01329-6

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