Background: Anthracyclines are widely used chemotherapeutic agents in several cancers.
Since its use, survival improved significantly among cancer patients and has been reported to
be up to 80%. However, anthracyclines possess several cardiac, renal and hematological toxicities
which limit their use in practice. Cardiotoxicity is still the most important and dose-limiting side
effect of anthracycline treatment. Here we aimed to investigate the frequency of anthracyclineinduced
cardiomyopathy in pediatric malignancies in Khuzestan Province, Iran.
Methods: A total of 112 patients were enrolled in the present study. Patients were allocated to the
case or control group based on receiving anthracycline. Echocardiographic examinations were performed
by a cardiologist. Electrocardiograms were also recorded.
Results: We showed that cancer patients who underwent anthracycline treatment showed cardiomyopathy
as defined by lower LVEF (Left Ventricular Ejection Fraction) among patients (p =
0.041). Abnormal LVEF was reported with a frequency of about 9.5% in patients (p = 0.026). However,
LVFS (Left Ventricular Fraction Shortening), QRS voltage and QT interval did not differ
significantly between treatment and control groups. Our data analysis revealed that this difference is
mainly related to high cumulative dose since high cumulative dose of anthracycline (>300 mg/m2)
leads to lower LVEF and LVFS and higher QRS voltage in comparison with lower cumulative dose
(<300 mg/m2) and control group; but there was no significant difference between low dose and
control group. Different age groups and type of malignancy including hematological and solid tumors
did not show any significant differences for echocardiographic and electrocardiograms parameters.
Conclusion: In our study, lower LVEF among patients who received anthracyclines were mainly
related to a high cumulative dose of anthracyclines, which emphasizes the effect of cumulative dose
for cardiotoxic effects. Larger studies are needed to investigate possible other risk factors for cardiotoxicity.