1. bookVolume 25 (2017): Issue 2 (April 2017)
Journal Details
License
Format
Journal
eISSN
2284-5623
First Published
08 Aug 2013
Publication timeframe
4 times per year
Languages
English
access type Open Access

The use of biomarkers in detecting subclinical cardiotoxicity in doxorubicin-based treatment for paediatric patients with acute lymphoblastic leukaemia

Published Online: 28 Apr 2017
Page range: 157 - 164
Received: 29 Jan 2016
Accepted: 01 Apr 2017
Journal Details
License
Format
Journal
eISSN
2284-5623
First Published
08 Aug 2013
Publication timeframe
4 times per year
Languages
English
Abstract

The international standard protocol for acute lymphoblastic leukaemia (ALL), the most common haemato-oncological pathology at paediatric age, uses anthracyclines as antitumor agents, potentially associated with early or late onset cardiac damage. Currently, echocardiography is the gold standard in the diagnosis of cardiotoxicity, but several biomarkers are evaluated as a possible replacement, pending more extensive clinical studies. We started a prospective study in order to determine the role of two biomarkers, troponin and heart-type fatty acid binding protein, in the evaluation of cardiotoxicity in children over one year of age, diagnosed with ALL. Between February 2015 and April 2016, 20 patients were enrolled and monitored at diagnosis, during chemotherapy and four months after the end of reinduction, through cardiac evaluation and dosing of those two markers in five different points of the treatment protocol. During the first year of follow-up, the patients did not develop clinical signs of cardiac damage, but the study showed a slight increase in troponin levels during chemotherapy, with the return to baseline value after treatment cessation, and also a correlation with the total dose of anthracyclines given to the patient. On the other hand, the second biomarker, heart-type fatty acid binding protein, did not seem to be useful in detecting subclinical cardiac damage in these patients.

Keywords

1. Harake D, Franco VI, Henkel JM, Miller TL, Lipshultz SE. Cardiotoxicity in childhood cancer survivors: strategies for prevention and management. Future Cardiol. 2012;8(4):647-70. DOI: 10.2217/fca.12.4410.2217/fca.12.44Search in Google Scholar

2. Gillespie HS, McGann CJ, Wilson BD. Noninvasive diagnosis of chemotherapy related cardiotoxicity. Curr Cardio Rev. 2011; 7: 234-44. DOI: 10.2174/15734031179996067210.2174/157340311799960672Search in Google Scholar

3. Vejpongsa P, Yeh ET. Prevention of anthracycline-induced cardiotoxicity: challenges and opportunities. J Am Coll Cardiol. 2014; 64(9): 938-45. DOI: 10.1016/j. jacc.2014.06.1167Search in Google Scholar

4. Tian S, Hirshfield KM, Jabbour SK, Toppmeyer D, Haffty BG, Khan AJ, Goyal S. Serum biomarkers for the detection of cardiac toxicity after chemotherapy and radiation therapy in breast cancer patients. Front Oncol. 2014;4:277. DOI: 10.3389/fonc.2014.0027710.3389/fonc.2014.00277Search in Google Scholar

5. Christenson ES, James T, Agrawal V, Park BH. Use of biomarkers for the assessment of chemotherapy-induced cardiac toxicity. Clin Biochem. 2015;48(4-5):223-35. DOI: 10.1016/j.clinbiochem.2014.10.01310.1016/j.clinbiochem.2014.10.013Search in Google Scholar

6. Van der Pal HJ, van Dalen EC, van Delden E, van Dijk IW, Kok WE, Geskus RB et al. High risk of symptomatic cardiac events in childhood cancer survivors. J Clin Oncol. 2012;30(13):1429-37. DOI: 10.1200/ JCO.2010.33.473010.1200/JCO.2010.33.4730Search in Google Scholar

7. Blanco JG, Sun CL, Landier W, Chen L, Esparza-Duran D, Leisenring W et al. Anthracycline-related cardiomyopathy after childhood cancer: role of polymorphisms in carbonyl reductase genes- a report forn the Children’s Oncology Group. J Clin Oncol. 2012; 30(13):1415-21. DOI: 10.1200/JCO.2011.34.898710.1200/JCO.2011.34.8987Search in Google Scholar

8. Wallace KB, Hausner E, Herman E, Holt GD, MacGregor JT, Metz AL et al. Serum troponins as biomarkers of drug-induced cardiac toxicity. Toxicol Pathol. 2014;32(1):106-21. DOI: 10.1080/0192623049026130210.1080/01926230490261302Search in Google Scholar

9. Azzazy HM, Persers MM, Christenson RH. Unbound free fatty acid-binding protein: diagnosis assays and clinical applications. Clin Chem. 2006;52(1):19-29. DOI: 10.1373/clinchem.2005.05614310.1373/clinchem.2005.056143Search in Google Scholar

10. Liao J, Chan CP, Cheung YC, Lu JH, Luo Y, Cautherley GW et al. Human heart-type fatty acid-binding protein for on-site diagnosis of early acute myocardial infarction. Int J Cardiol. 2009;133(3):420-3. DOI: 10.1016/j. ijcard.2008.01.049Search in Google Scholar

11. Jacobs LH, van Borren M, Gemen E, van Eck M, van Son B, Glatz JF, et al. Rapidly rule out acute myocardial infarction by combining copeptin and heat-type fatty acid-binding protein with cardiac troponin. Ann Clin Biochem. 2015;52(5):550-61. DOI: 10.1177/000456321557818910.1177/0004563215578189Search in Google Scholar

12. Glatz JF, van der Vusse GJ, Simoons ML, Kragten JA, van Dieijen-Visser MP, Hermens WT. Fatty acid-binding protein and the early detection of acute myocardial infarction. Clin Chim Acta. 1998;272(1):87-92. DOI: 10.1016/S0009-8981(97)00255-6 10.1016/S0009-8981(97)00255-6Search in Google Scholar

Recommended articles from Trend MD

Plan your remote conference with Sciendo