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Cardiology Research and Practice
Volume 2011, Article ID 316927, 8 pages
http://dx.doi.org/10.4061/2011/316927
Research Article

Cardiac Function in Long-Term Survivors of Childhood Lymphoma

1Department of Pediatrics, Meyer Children's Hospital, Rambam Medical Center, Technion-Israel Institute of Technology, Haifa 31096, Israel
2Division of Obstetrics and Gynecology, Meyer Children's Hospital, Rambam Medical Center, Technion-Israel Institute of Technology, Haifa 31096, Israel
3Department of Pediatric Hematology and Oncology, Meyer Children's Hospital, Rambam Medical Center, Technion-Israel Institute of Technology, Haifa 31096, Israel
4Unit of Pediatric Cardiology, Meyer Children's Hospital, Rambam Medical Center, Technion-Israel Institute of Technology, Haifa, 31096, Israel

Received 3 November 2010; Revised 4 January 2011; Accepted 4 January 2011

Academic Editor: Dirk Westermann

Copyright © 2011 Mark K. Friedberg et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. We studied long-term effects of therapy for childhood lymphoma on cardiac function. Design and patients. We prospectively evaluated 45 survivors of childhood lymphoma, using clinical parameters, electrocardiography and echocardiography. Further comparisons were made between lymphoma subgroups and between males and females. Results. Mean age at diagnosis was 9.1 years. Mean followup duration was 10.9 years. The NYHA functional class was I in 43 patients and II in 2 patients. A prolonged QTc interval (>0.44 msec) was found in 8 patients. Left ventricular (LV) systolic function and compliance were normal (LV shortening fraction 4 0 ± 5 . 6 %; cardiac index 2 . 8 4 ± 1 . 1 3 L/min/m2; E/A wave ratio 2 . 5 ± 1 . 3 ; mean ± S.D.), LV mass was normal ( 9 7 ± 4 0 grams/m2, mean ± S.D.). Mitral regurgitation was observed in 7/45 patients (16%). Asymptomatic pericardial effusions were found in 3/45 (7%) patients. Conclusions. Long-term follow-up shows that most parameters of cardiac function are normal in survivors of childhood lymphoma. This is likely due to relatively low doses of anthracyclines in modern protocol modalities. Abnormalities in mitral valve flow, QTc prolongation and in a small proportion of survivors, and functional capacity necessitate long-term cardiac follow-up of these patients.