Review of Cardiotoxicity in Pediatric Cancer Patients: During and after Therapy

Table 1

Cancer therapies utilized in pediatric population associated with cardiotoxicity.

Type of therapy	Dose that places at highest risk	Time of usual presentation	Cardiac manifestations
Radiation therapy [5]	>30 gray to heart	Up to decades after treatment has ended	Pericarditis, coronary artery disease, valvular disease, arrythmias
Anthracyclines [6, 7]	>300 mg/m^2 doxorubicin isotoxic cumulative dose	Acute: during therapy; Chronic: months to years posttherapy (longer follow higher the incidence)	Acute-arrythmias, hypotension; Chronic-CHF
Cyclophosphamide [8, 9]	>150 mg/kg or >1.55 g/m^2 given as one dose or per one course	ECG changes: 1–3 days after therapy; CHF: up to 2 weeks after therapy	CHF, Myocarditis
Cytarabine [8, 9]	High doses	3–28 days after initiation of therapy	Pericarditis, ventricular, and atrial arrythmias
Cisplatin [8, 9]	Usually when receiving with other chemotherapy	Arrythmias/hypotension: acute within hours; Vascular toxicities: usually days after infusion but reports 4 and 18 mths post therapy	Arrythmias; Vascular toxicities (CVA, AMI)
Ifosfamide [9, 10]	Higher doses	6–23 days after first dose	CHF, arrythmias

CHF: Congestive Heart Failure, ECG: Electrocardiogram.