Use of cardiac markers to assess the toxic effects of anthracyclines given to children with cancer: a systematic review.
Bryant, J;
Picot, J;
Baxter, L;
Levitt, G;
Sullivan, I;
Clegg, A;
(2007)
Use of cardiac markers to assess the toxic effects of anthracyclines given to children with cancer: a systematic review.
European journal of cancer (Oxford, England, 43 (13).
pp. 1959-1966.
ISSN 0959-8049
DOI: https://doi.org/10.1016/j.ejca.2007.06.012
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AIM: To evaluate the effectiveness of cardiac markers to quantify anthracycline-induced cardiotoxicity in children with cancer. METHODS: Systematic review using a priori methods. RESULTS: Seven studies, all with methodological limitations, were identified. One RCT suggests that cardiac troponin can be used to assess the effectiveness of the cardio-protective agent dexrazoxane. Cohort studies suggest that atrial natriuretic peptide and brain (B-type) natriuretic peptide are elevated in some subgroups of patients compared with healthy children; NT-pro-BNP levels are significantly elevated in children with cardiac dysfunction compared with those without; serum lipid peroxide is higher in children who have received doxorubicin compared with children not receiving doxorubicin; there are no differences in carnitine levels between children treated with doxorubicin and a healthy control group. CONCLUSIONS: The limited evidence makes conclusions difficult. Research is needed to fill this important evidence gap and link short-term changes in cardiac markers to longer-term cardiac damage.