The usefulness of cardiac biomarkers for cardiac evaluation in children with leukemia treated with anthracyclines
Journal Title: Postępy Nauk Medycznych - Year 2011, Vol 24, Issue 12
Abstract
The introduction of anthracyclines to treatment protocols for acute leukemias has contributed to significant improvement in treatment outcomes, mortality reduction and prolongation of survival, however, it is associated with the occurrence of adverse effects, of which the most serious is damage to the myocardium.<br>The paper presents the usefulness of the determination NT-proBNP measurment in the diagnostics of early and late anthracycline-induced cardiotoxicity. <br>The study included 156 children aged from 9 months to 17 8/12 years, treated for acute lymphoblastic leukemia, with anthracyclines in a dose 180-480 mg/m<sup>2</sup>. In all the children plasma NT-proBNP and troponin T was measured. In 128 children (82%) simultaneously with plasma level echocardiography with the assessment of left ventricular systolic function was performed. All the assessments were performed before and after anthracycline therapy. <br>Almost half of the determinations of plasma NT-proBNP (42.3%) was above the median of the levels found in the control group. Most elevated NT-proBNP levels (28.7%) occurred in the children monitored up to three years since the completion of anthracycline therapy. In children receiving an anthracycline dose of more than 240 mg/m<sup>2</sup> studied in the fourth and fifth years after anthracycline therapy, the lower levels of fractional shortening (%SF) and ejection fraction (%EF) correlated with the higher levels of plasma NT-proBNP (p = 0.08 and p = 0.09, respectively). In none of the children there was an elevated level of plasma troponin T found. <br>Measurements of plasma NT-proBNP levels proved to be useful for monitoring cardiotoxicity in children with acute lymphoblastic leukemia treated with anthracyclines.
Authors and Affiliations
Teresa Jackowska, Robert Wasilewski, Małgorzata Gołąbek
Keywords
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