Cardiovascular Toxicology

, Volume 7, Issue 2, pp 122–128

Anthracycline cardiotoxicity in long-term survivors of childhood cancer



Anthracycline chemotherapy is a widely-used and effective treatment for a wide spectrum of childhood cancers. Its use is limited by associated progressive and clinically significant cardiotoxic effects. Onset can be acute, early, or late. While acute onset is rare, long-term survivors have significantly elevated rates of cardiac morbidity and mortality. Major complications include cardiomyopathy, coronary artery disease, and atherosclerosis. Means of prevention and treatment continue to be explored including limiting cumulative anthracycline dose, controlling the rate of administration, and using liposomal preparations and novel anthracycline analogues. Dexrazoxane prior to anthracycline chemotherapy has been shown to significantly lower rates of elevated serum cardiac troponin levels, a marker of myocyte injury, indicating a cardioprotective effect. Pilot studies indicate that exercise interventions may also be beneficial in long-term survivors with cardiac damage. Support and study of this population to decrease the morbidity and morality associated with anthracycline-induced cardiotoxicity is indicated in a time sensitive fashion.


Anthracyclines Cardiotoxicity Treatment effects Cardiomyopathy Survivorship Childhood cancer 

Copyright information

© Humana Press Inc. 2007

Authors and Affiliations

  1. 1.Department of Pediatrics, Division of Pediatric Clinical ResearchUniversity of Miami Miller School of MedicineMiamiUSA
  2. 2.Department of Pediatrics, Mailman Center for Child DevelopmentUM Miller School of MedicineMiamiUSA
  3. 3.Holtz Children’s Hospital of the University of Miami/Jackson Memorial Medical CenterMiamiUSA
  4. 4.Sylvester Comprehensive Cancer CenterMiamiUSA

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