Anthracycline-Induced Cardiotoxicity: Causes, Mechanisms, and Prevention
Anthracycline-Induced Cardiotoxicity: Causes, Mechanisms, and Prevention
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DOI：
10.1007/978-3-030-43032-0_15
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发表时间：
2020-01-01
期刊：
影响因子：
--
通讯作者：
Kleinerman, Eugenie S.
中科院分区：
文献类型：
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作者：
Bhagat, Anchit;Kleinerman, Eugenie S.
阿霉素是一种蒽环类药物，也是治疗儿童、青少年和成人骨肉瘤较为有效的化疗药物之一。尽管心脏毒性是有效的，但它是一种主要的晚期效应，危及这种癌症和其他癌症幸存者的生存和生活质量。心脏毒性是指心脏无法有效地将血液输送到身体各处。阿霉素引起的心脏毒性具有剂量依赖性。此外，患者的年龄在易感性中起着作用，在治疗完成数年后，较年轻的患者发生心脏毒性和心力衰竭的风险更大。阿霉素心脏毒性的确切机制(S)尚不清楚，需要做进一步的研究来阐明其机制。本章总结了已确定的可能在蒽环类药物引起的心脏毒性中发挥作用的机制。我们还将总结在接受阿霉素治疗的幸存者中描述的心肌病的类型，以及目前监测幸存者发展心肌病的建议。将包括对定义早期生物标记物的重要搜索，以识别处于危险中的患者和幸存者。最后，我们将总结一些建议的干预措施，以减少蒽环类药物的心脏毒性。
Doxorubicin is an anthracycline and one of the more effective chemotherapy agents used in the treatment of children, adolescents, and adults with osteosarcoma. Despite its effectiveness, cardiotoxicity is a major late effect that compromises the survival and quality of life of survivors of this and other cancers. Cardiotoxicity is the inability of the heart to pump blood through the body effectively. Doxorubicin-induced cardiotoxicity is dose dependent. Additionally, the age of the patients plays a role in susceptibility with younger patients having a greater risk for cardiotoxicity and heart failure years after treatment is complete. The exact mechanism(s) responsible for doxorubicin-induced cardiotoxicity is poorly understood, and further research needs to be done to elucidate the mechanisms. This chapter summarizes the identified mechanisms that may play a role in anthracycline-induced cardiotoxicity. We will also summarize the types of cardiomyopathies that have been described in survivors treated with doxorubicin and the current recommendations for monitoring survivor for the development of cardiomyopathies. Included will be the important search for defining early biomarkers to identify patients and survivors at risk. Finally, we will summarize some of the interventions proposed for decreasing anthracycline-induced cardiotoxicity.