Author:
Toro Claudia,Felmingham Ben,Jhadav Mangesh,Celermajer David S.,La Gerche Andre,O’Sullivan John,Kumar Sanjeev,Mateos Marion K.,Fulbright Joy,Govender Dinisha,Collier Lane,Cheung Michael,Eisenstat David D.,Lange Peter W.,Ayer Julian,Elliott David A.,Conyers Rachel
Abstract
Abstract
Background
Modern oncological therapies together with chemotherapy and radiotherapy have broadened the agents that can cause cardiac sequelae, which can manifest for pediatric oncology patients while on active treatment. Recommendations for high-risk patients who should be monitored in a pediatric cardio-oncology clinic have previously been developed by expert Delphi consensus by our group. In 2022 we opened our first multidisciplinary pediatric cardio-oncology clinic adhering to these recommendations in surveillance and management.
Objectives
Our pediatric cardio-oncology clinic aimed to:
(i) Document cardiovascular toxicities observed within a pediatric cardio-oncology clinic and.
(ii) Evaluate the applicability of the Australian and New Zealand Pediatric Cardio-Oncology recommendations.
Methods
Monthly multidisciplinary cardio-oncology clinics were conducted in an Australian tertiary pediatric hospital. Structured standardised approaches to assessment were built into the electronic medical record (EMR). All patients underwent baseline echocardiogram and electrocardiogram assessment together with vital signs in conjunction with standard history and examination.
Results
Nineteen (54%) individuals had a documented cardiovascular toxicity or pre-existing risk factor prior to referral. The two most common cardiovascular toxicities documented during clinic review included Left Ventricular Dysfunction (LVD) and hypertension. Of note 3 (8.1%) patients had CTCAE grade III LVD. An additional 10 (27%) patients reviewed in clinic had CTCAE grade I hypertension. None of these patients had hypertension noted within their referral. Cascade testing for cardiac history was warranted in 2 (5.4%) of patients.
Conclusions
Pediatric cardio-oncology clinics are likely beneficial to documenting previously unrecognised cardiotoxicity and relevant cardiac family histories, whilst providing an opportunity to address lifestyle risk factors.
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine,Oncology
Reference26 articles.
1. National Cancer Institute D, Surveillance Research Program. SEER Cancer statistics review 1975–2016. 2019.
2. Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, et al. Chronic health conditions in adult survivors of childhood cancer. N Engl J Med. 2006;355(15):1572–82.
3. Toro C, Felmingham B, Jessop S, Celermajer David S, Kotecha Rishi S, Govender D, et al. Cardio-oncology recommendations for pediatric oncology patients. JACC: Advances. 2022;1(5)
4. Lai WW, Geva T, Shirali GS, Frommelt PC, Humes RA, Brook MM, et al. Guidelines and standards for performance of a pediatric echocardiogram: a report from the task force of the pediatric Council of the American Society of echocardiography. J Am Soc Echocardiogr. 2006;19(12):1413–30.
5. Common Terminology Criteria for Adverse Events (CTCAE) version 5.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献