Anthracycline‐Induced Cardiomyopathy After Nephro‐/Neuroblastoma in Childhood: The Importance of Cardiological Reference Assessment
ABSTRACT Background Long‐term childhood cancer survivors (CCS) may develop anthracycline‐induced cardiomyopathy. Our cross‐sectional study focused on the question of whether a central echocardiographic reference assessment is associated with a higher detection rate of cardiac dysfunction in a popula...
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| Language: | English |
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Wiley
2025-08-01
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| Series: | Cancer Medicine |
| Online Access: | https://doi.org/10.1002/cam4.71158 |
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| author | Kristina Kleen Judith Gebauer Claudia Spix Lea L. Kronziel Inke König Katja Baust Gabriele Calaminus Thorsten Simon Barbara Hero Oliver Zolk Norbert Graf Hashim Abdul‐Khaliq Thorsten Langer |
| author_facet | Kristina Kleen Judith Gebauer Claudia Spix Lea L. Kronziel Inke König Katja Baust Gabriele Calaminus Thorsten Simon Barbara Hero Oliver Zolk Norbert Graf Hashim Abdul‐Khaliq Thorsten Langer |
| author_sort | Kristina Kleen |
| collection | DOAJ |
| description | ABSTRACT Background Long‐term childhood cancer survivors (CCS) may develop anthracycline‐induced cardiomyopathy. Our cross‐sectional study focused on the question of whether a central echocardiographic reference assessment is associated with a higher detection rate of cardiac dysfunction in a population‐based cohort of affected children with neuroblastoma or nephroblastoma. We also examined the prevalence of anthracycline‐induced cardiomyopathy and its risk factors. Methods and Patients The cohort of this subproject comprises 370 nephroblastoma or neuroblastoma survivors diagnosed with cancer between 1990 and 2012. At study entry, participants were younger than 18 years old, had been treated with anthracyclines, and had no documented previous cardiac disease. Data were collected via patient questionnaires, cardiologic examinations in the network of adults with congenital heart defects (Erwachsene mit angeborenem Herzfehler [EMAH]) and a reference assessment of the recorded echocardiography. Results The prevalence of cardiomyopathy in the study cohort (mean age: 12 years) was 6.3% at a median of 9.1 years after initial cancer diagnosis. Risk factors were an age under 5 years at tumor diagnosis and concomitant treatment with cyclophosphamide or radiation. As a central and novel finding, the detection rates by the EMAH cardiologists and the reference center are similarly high but discrepant. Discussion Limitations were mainly due to the low responder rate and incomplete data. This study established a nationwide competence network linking pediatric oncology and cardiology centers across six university hospitals in Germany, enabling data collection on pediatric CCS. Despite lower case numbers compared to adult CCS cohorts, meaningful data were gathered and analyzed. Conclusion Cardiac late effects after anthracycline‐based therapy in childhood affect a relevant proportion of long‐term CCS at pediatric age. In order to enable timely diagnosis and treatment, preventive examinations are essential and might benefit from additional central reference assessments. Discrepancy in detection of cardiomyopathy by reference and EMAH cardiologists requires further investigation. |
| format | Article |
| id | doaj-art-e5571292d2784186a9484ea79f8b7e44 |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-e5571292d2784186a9484ea79f8b7e442025-08-26T10:58:44ZengWileyCancer Medicine2045-76342025-08-011416n/an/a10.1002/cam4.71158Anthracycline‐Induced Cardiomyopathy After Nephro‐/Neuroblastoma in Childhood: The Importance of Cardiological Reference AssessmentKristina Kleen0Judith Gebauer1Claudia Spix2Lea L. Kronziel3Inke König4Katja Baust5Gabriele Calaminus6Thorsten Simon7Barbara Hero8Oliver Zolk9Norbert Graf10Hashim Abdul‐Khaliq11Thorsten Langer12Paediatric Haematology and Oncology, Department of Paediatrics and Adolescent Medicine University Hospital Schleswig‐Holstein Lübeck GermanyMedical Clinic 1 University Hospital Schleswig‐Holstein Lübeck GermanyGerman Childhood Cancer Registry Mainz GermanyInstitute of Biometry and Statistics, University of Lübeck Lübeck GermanyInstitute of Biometry and Statistics, University of Lübeck Lübeck GermanyPaediatric Haematology and Oncology University Hospital Bonn Bonn GermanyPaediatric Haematology and Oncology University Hospital Bonn Bonn GermanyPaediatric Oncology and Haematology University Hospital Cologne Cologne GermanyPaediatric Oncology and Haematology University Hospital Cologne Cologne GermanyInstitute for Clinical Pharmacology Immanuel Clinic Rüdersdorf, Brandenburg Medical School Rüdersdorf GermanyPaediatric Haematology and Oncology University Hospital Homburg/Saar Homburg GermanyPaediatric Cardiology University Hospital Homburg/Saar Homburg GermanyPaediatric Haematology and Oncology, Department of Paediatrics and Adolescent Medicine University Hospital Schleswig‐Holstein Lübeck GermanyABSTRACT Background Long‐term childhood cancer survivors (CCS) may develop anthracycline‐induced cardiomyopathy. Our cross‐sectional study focused on the question of whether a central echocardiographic reference assessment is associated with a higher detection rate of cardiac dysfunction in a population‐based cohort of affected children with neuroblastoma or nephroblastoma. We also examined the prevalence of anthracycline‐induced cardiomyopathy and its risk factors. Methods and Patients The cohort of this subproject comprises 370 nephroblastoma or neuroblastoma survivors diagnosed with cancer between 1990 and 2012. At study entry, participants were younger than 18 years old, had been treated with anthracyclines, and had no documented previous cardiac disease. Data were collected via patient questionnaires, cardiologic examinations in the network of adults with congenital heart defects (Erwachsene mit angeborenem Herzfehler [EMAH]) and a reference assessment of the recorded echocardiography. Results The prevalence of cardiomyopathy in the study cohort (mean age: 12 years) was 6.3% at a median of 9.1 years after initial cancer diagnosis. Risk factors were an age under 5 years at tumor diagnosis and concomitant treatment with cyclophosphamide or radiation. As a central and novel finding, the detection rates by the EMAH cardiologists and the reference center are similarly high but discrepant. Discussion Limitations were mainly due to the low responder rate and incomplete data. This study established a nationwide competence network linking pediatric oncology and cardiology centers across six university hospitals in Germany, enabling data collection on pediatric CCS. Despite lower case numbers compared to adult CCS cohorts, meaningful data were gathered and analyzed. Conclusion Cardiac late effects after anthracycline‐based therapy in childhood affect a relevant proportion of long‐term CCS at pediatric age. In order to enable timely diagnosis and treatment, preventive examinations are essential and might benefit from additional central reference assessments. Discrepancy in detection of cardiomyopathy by reference and EMAH cardiologists requires further investigation.https://doi.org/10.1002/cam4.71158 |
| spellingShingle | Kristina Kleen Judith Gebauer Claudia Spix Lea L. Kronziel Inke König Katja Baust Gabriele Calaminus Thorsten Simon Barbara Hero Oliver Zolk Norbert Graf Hashim Abdul‐Khaliq Thorsten Langer Anthracycline‐Induced Cardiomyopathy After Nephro‐/Neuroblastoma in Childhood: The Importance of Cardiological Reference Assessment Cancer Medicine |
| title | Anthracycline‐Induced Cardiomyopathy After Nephro‐/Neuroblastoma in Childhood: The Importance of Cardiological Reference Assessment |
| title_full | Anthracycline‐Induced Cardiomyopathy After Nephro‐/Neuroblastoma in Childhood: The Importance of Cardiological Reference Assessment |
| title_fullStr | Anthracycline‐Induced Cardiomyopathy After Nephro‐/Neuroblastoma in Childhood: The Importance of Cardiological Reference Assessment |
| title_full_unstemmed | Anthracycline‐Induced Cardiomyopathy After Nephro‐/Neuroblastoma in Childhood: The Importance of Cardiological Reference Assessment |
| title_short | Anthracycline‐Induced Cardiomyopathy After Nephro‐/Neuroblastoma in Childhood: The Importance of Cardiological Reference Assessment |
| title_sort | anthracycline induced cardiomyopathy after nephro neuroblastoma in childhood the importance of cardiological reference assessment |
| url | https://doi.org/10.1002/cam4.71158 |
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