Late cardiotoxicity by anthracyclines used for treatment of acute lymphoblastic leukemia in pediatric age

Abstract

Introduction: the acute lymphoblastic leukemias diagnosed in prediatric age are treated with anthracyclines which offers good results. However, these drugs produce cardiotoxicity, which limits their use.

Objective: to identify the subclinical alterations of late cardiotoxicity caused by anthracyclines used in patients with acute lymphoblastic leukemia in pediatric age.

Method: a preexperiment was carried out with post-test between September 2015 and December 2016. The population under study was constituted by the 18 patients treated in the Oncology Department of the Pediatric Hospital in Camagüey, who underwent an electrocardiogram and two-dimensional echocardiogram, Doppler and color flow, and calculated the cumulative dose of anthracyclines in mg/m² of body surface area.

Results: the female sex predominated (61,11 %), almost all patients were 10 or more years old, 83,33 % showed signs of late cardiotoxicity. Electrocardiographic alterations prevailed (86,67 %) due to sinus tachycardia, on echocardiography (13,33 %) due to an increase in diastolic diameter of the left ventricle. Cardiotoxicity was identified even in those who received the lowest dose (180 mg/m² and 240 mg/m²) and in all those who received the treatment for two years or more. The echocardiographic signs appeared with the highest doses (600 mg/m² to 720 mg/m²) while the electrocardiographic signs appeared for the other doses of the drug.

Conclusions: the electrocardiographic alterations prevailed over echocardiography. Cardiotoxicity occurred even when the time of exposure to the drug was short and the doses were low