natriuretic-peptide--brain and Hodgkin-Disease

Childhood cancer survivors treated with anthracyclines and mediastinal irradiation are at risk for late onset cardiotoxicity.. To assess the role of N-terminal pro-brain natriuretic peptide (NT-proBNP) and tissue Doppler imaging (TDI) as early predictors of late onset cardiotoxicity in asymptomatic survivors of childhood cancer treated with doxorubicin with or without mediastinal irradiation.. A cross-sectional study on 58 asymptomatic survivors of childhood cancer who received doxorubicin in their treatment protocols and 32 asymptomatic Hodgkin's lymphoma survivors who received anthracycline and mediastinal irradiation. Levels of NT-proBNP, TDI, and conventional echocardiography were determined.. Thirty percent of survivors had abnormal NT-proBNP levels. It was significantly related to age at diagnosis, duration of follow-up, and cumulative dose of doxorubicin. TDI detected myocardial affection in 20% more than conventional echocardiography. Furthermore, abnormalities in TDI and NT-pro-BNP levels were more common in Hodgkin lymphoma survivors receiving both chemotherapy and radiotherapy.. TDI could detect early cardiac dysfunction even in those with normal conventional echocardiography. Measurement of NT-proBNP represents an interesting strategy for detecting subclinical cardiotoxicity. We recommend prospective and multicenter studies to validate the role of NT-proBNP as an early marker for late onset doxorubicin-induced cardiotoxicity.

Topics: Antineoplastic Agents; Biomarkers; Cardiotoxicity; Child; Child, Preschool; Doxorubicin; Female; Heart Diseases; Hodgkin Disease; Humans; Male; Natriuretic Peptide, Brain; Peptide Fragments; Radiotherapy; Survivors

The study objective was to assess plasma N-terminal-pro-brain natriuretic peptide (BNP) levels and to evaluate left ventricular mass as well as left ventricular systolic and diastolic functions in 44 children who had undergone treatment for acute lymphoblastic leukaemia and Hodgkin's lymphoma, with regard to gender, age at disease onset, time that had passed since therapy completion, cumulative dose of antracyclines and mediastinal radiotherapy applied.. The median levels of pro-BNP were found to be higher in the whole study group as compared with the control (55.9 ± 53.1 ng/mL vs. 38.5 ± 47.7 ng/mL, P= 0.059). The pro-BNP values >80.0 ng/mL (standard deviation score (SDS)) were noted in 11/44 patients, including those exceeding 115.0 ng/mL (2 SDS) - in 6/44 patients.. No correlation was observed of pro-BNP levels with the accumulated dose of antracyclines (r=-0.42, P= 0.79) or mediastinal radiotherapy (r= 0.197, P= 0.2). However, negative correlation was found between pro-BNP and the time that had passed since therapy completion (r=-0.378, P= 0.009). In echocardiography, shortening and ejection fractions remained normal, whereas the indexed stroke volume was below 40 mL/m(2) in 16/44 patients. The E/A index below 1.5 was found in 6/44 cases. The left ventricular systolic mass remained within the normal range. Negative correlation was noted between isovolumetric diastolic time and pro-BNP level.. Increased levels of pro-BNP after anti-cancer treatment with the involvement of cardiotoxic substances may indicate the first symptoms of myocardial dysfunction, despite the lack of major echocardiographic disorders.

Topics: Adolescent; Anthracyclines; Antibiotics, Antineoplastic; Biomarkers; Chemoradiotherapy; Child; Diastole; Echocardiography; Female; Follow-Up Studies; Heart Ventricles; Hodgkin Disease; Humans; Male; Natriuretic Peptide, Brain; Peptide Fragments; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Radiation Injuries; Stroke Volume; Ventricular Function, Left; Young Adult