Abstract 10662: Myocardial 2D Strain Echocardiography and Cardiac Biomarkers in Children During and Shortly After Anthracycline Therapy for Acute Lymphoblastic Leukemia (ALL). A Prospective Study
Objective: Previous studies have demonstrated that cardiac function is decreased in asymptomatic long-term survivors of childhood cancer. In this study, we aim to investigate cardiac function in children with Acute Lymphoblastic Leukemia (ALL) during and shortly after treatment with anthracyclines.
Methods: In a prospective study, we monitored cardiac function of 60 children treated for ALL with conventional echocardiography, myocardial 2D strain echocardiography and levels of the cardiac biomarkers Troponin T (cTnT), N-Terminal-pro-brain natriuretic peptide (NT-pro-BNP) before start (T=0), after three months (T=1) and after one year of treatment with anthracyclines (T=2) and compared it to 60 healthy controls. At T=1, the cumulative anthracycline dosage of all patients was 120 mg/m2. Further anthracycline dose was dependent on risk stratification.
Results: Cardiac function decreased significantly during treatment with anthracyclines and was significantly decreased compared to normal controls as measured by conventional and myocardial 2D strain echocardiography. Although FS stayed normal in all patients, it decreased throughout treatment with anthracyclines. The cumulative anthracycline dose correlated negatively with longitudinal strain (p=0.004) and longitudinal strain rate (p=0.03) and radial strain (p=0.006). Abnormal cTnT levels were documented in 11% of the patients at T=1 and were significantly related to increased time to peak systolic longitudinal strain at T=2 (p=0.003). NT-pro-BNP levels were abnormal in 13% of patients at T=1 and in 20% at T=2. Absolute values of NT-pro-BNP increased throughout treatment in 59% of the patients.
Conclusion: We concluded that children with ALL treated with anthracyclines showed decreased systolic and diastolic function during treatment with anthracyclines and compared to healthy controls as measured by myocardial strain echocardiography and cardiac biomarkers.
- © 2011 by American Heart Association, Inc.