Managing Chemotherapy-Related Cardiotoxicity in Survivors of Childhood Cancers

Steven E. Lipshultz, Melissa B. Diamond, Vivian I. Franco, Sanjeev Aggarwal, Kasey Leger, Maria Verônica Santos, Stephen E. Sallan, Eric J. Chow

Research output: Contribution to journalReview articlepeer-review

34 Scopus citations


In the US, children diagnosed with cancer are living longer, but not without consequences from the same drugs that cured their cancer. In these patients, cardiovascular disease is the leading cause of non-cancer-related morbidity and mortality. Although this review focuses on anthracycline-related cardiomyopathy in childhood cancer survivors, the global lifetime risk of other cardiovascular diseases such as atherosclerosis, arrhythmias and intracardiac conduction abnormalities, hypertension, and stroke also are increased. Besides anthracyclines, newer molecularly targeted agents, such as vascular endothelial growth factor receptor and tyrosine kinase inhibitors, also have been associated with acute hypertension, cardiomyopathy, and increased risk of ischemic cardiac events and arrhythmias, and are summarized here. This review also covers other risk factors for chemotherapy-related cardiotoxicity (including both modifiable and non-modifiable factors), monitoring strategies (including both blood and imaging-based biomarkers) during and following cancer treatment, and discusses the management of cardiotoxicity (including prevention strategies such as cardioprotection by use of dexrazoxane).

Original languageEnglish
Pages (from-to)373-389
Number of pages17
JournalPediatric Drugs
Issue number5
StatePublished - Oct 2014


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