Cardiac toxicity in survivors of childhood cancer


Session type:

Leontien C. Kremer1
1University of Amsterdam, Amsterdam, The Netherlands


Progress in therapy in pediatric oncology during the last 3 decades has resulted in a dramatic increase in survival of children with cancer. Currently, nearly 80% of the children survive more than 5 years after diagnosis. The prevalence of cancer survivors among young adults (15 to 45 years of age) has been predicted to be one in 250 persons at this moment. However, improved prognosis of childhood cancer has been accompanied by the occurrence of late treatment-related complications, some of which are life threatening. Cardiac disease after cancer treatment, especially anthracyclines and radiation therapy, is one of the most important causes of late mortality and morbidity in childhood cancer survivors (CCS) and manifests itself as either clinical heart failure or asymptomatic heart failure, myocardial infarction, valvular disease or pericarditis or death due to cardiac disease. Mortality from cardiac disease among CCS is, on average, 6 to 8-fold elevated compared to the general population. The excess risk appears to be life-long and even increases over time.

The focus of the presentation are the incidence, prevalence and associated risk factors, the possible prevention of cardiotoxicity and recommendations for long term follow-up.