Onkológia 4/2010

The role of biomarkers in cardiotoxicity detection in childhood cancer survivors

Background: Late cardiac complications in cancer survivors may develop from subclinical myocardial damage. Biochemical correlates of myocardial changes are spreading to early detection of cardiac toxicity. The aim of this study was to evaluate the role of biochemical markers for early detection of subclinical cardiotoxicity in childhood cancer survivors. Methods: Study population of acute leukemia and lymphoma survivors was divided into two treatment groups: 31 patients previously treated with anthracyclines (ANT group) and 32 patients who underwent chemotherapy without ANT (nonANT group). The total cumulative doses of anthracyclines were 75 − 600 (median 200) mg/m2. Analyses of cardiac troponin T (cTnT) and N-terminal fragment of the brain natriuretic peptide precursor (NT-proBNP) were performed in the whole study population and 22 controls. Results: Patients treated with anthracyclines had significantly higher NT-proBNP values median (range) 49.6 pg/ml (<5.0 – 218.1 pg/ml) as both controls 19.3 pg/ml (<5.0 – 41.4 pg/ml) (p<0.01) and nonANT group 14.9 pg/ml (<5.0 – 129.3 pg/ml) (p<0.01). We did not observed any significant elevations in nonANT patients when compared to controls. CTnT remained below the diagnostic cut-off values in both groups and controls. Conclusion: Significant increase in NT-proBNP values in anthracycline treated patients may alert the subclinical cardiac impairment. The further follow-up will be needed to confirm this result.

Keywords: anthracyclines, cardiotoxicity, natriuretic peptides, cardiac troponins.