Clinical heart failure in a cohort of children treated with anthracyclines: A long-term follow-up study
Clinical heart failure in a cohort of children treated with anthracyclines: A long-term follow-up study
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DOI：
10.1016/j.ejca.2006.08.005
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发表时间：
2006-12-01
影响因子：
8.4
通讯作者：
Kremer, Leontien C. M.
中科院分区：
文献类型：
--
作者：
van Dalen, Elvira C.;van der Pal, Helena J. H.;Kremer, Leontien C. M.
在830名接受平均累积剂量为288毫克/米(2)(中位数280毫克/米(2)；范围15-900毫克/米(2))，并在开始使用蒽环类药物后获得很长时间的完整随访(平均8.5年；中位7.1年；范围0.01-28.4年)的830名儿童中，由蒽环类药物引起的临床心力衰竭(A-CHF)的累积发生率为2.5%。蒽环类药物累积剂量大于或等于300 mg/m(2)是唯一的独立危险因素(相对危险度(RR)=8)。在开始使用蒽环类药物治疗20年后，A-CHF的估计风险随着时间的推移而增加到5.5%；如果接受300 mg/m(2)或更高剂量的治疗，则风险为9.8%。总而言之，每10名接受累计剂量300 mg/m(2)或更高剂量的蒽环素治疗的儿童中，就有1人最终会发展为A-CHR。这是一个极高的风险，它强化了重新评估不同治疗方案中使用的累计蒽环类药物剂量并制定预防A-CHF的策略的必要性，这些策略可以在治疗方案中实施。(C)2006爱思唯尔有限公司。保留所有权利。
The cumulative incidence of anthracycline-induced clinical heart failure (A-CHF) in a large cohort of 830 children treated with a mean cumulative anthracycline dose of 288 mg/m(2) (median 280 mg/m(2); range 15-900 mg/m(2)) with a very long and complete follow-up after the start of anthracycline therapy (mean 8.5 years; median 7.1 years; range 0.01-28.4 years) was 2.5%. A cumulative anthracycline dose of 300 mg/m(2) or more was the only independent risk factor (relative risk (RR) = 8). The estimated risk of A-CHF increased with time to 5.5% at 20 years after the start of anthracycline therapy; 9.8% if treated with 300 mg/m(2) or more.In conclusion, 1 in every 10 children treated with a cumulative anthracychne dose of 300 mg/m(2) or more will eventually develop A-CHR This is an extremely high risk and it reinforces the need of re-evaluating the cumulative anthracycline dose used in different treatment protocols and to define strategies to prevent A-CHF which could be implemented in treatment protocols. (c) 2006 Elsevier Ltd. All rights reserved.