Abnormal NT-pro-BNP Levels in Asymptomatic Long-Term Survivors of Childhood Cancer Treated With Anthracyclines

Background. Anthracycline-induced cardiotoxicity can cause serious health problems for in increasing number of survivors of childhood malignancies. The aims Of this study were to (document plasma concentrations of cardiac troponin T (cTnT) and NT-probrain natriuretic peptide (NT-pro-BNP) in a large group Of asymptomatic long-term survivors of childhood cancer treated with anthracyclines, and to study the relation of the abnormal biomarker levels with different risk factors for anthracycline-induced cardiotoxicity and conventional echocardiographic parameters. Procedures. One hundred twenty two asymptomatic survivors Of childhood cancer underwent a detailed echocardiography. Blood samples were taken to determine the levels of NT-pro-BNP and cTnT. Results. None of the survivors had abnormal (TOT levels. Thirteen percent Of the Survivors (n = 16) had abnormal NT-pro-BNP levels. Abnormal NT-pro-BNP levels were significantly related to cumulative anthracycline dosage (P<0.003). Eleven of 31 survivors (35%) treated with cumulative anthracycline dose of WO mg/m(2) or more, had abnormal NT-pro-BNP levels which were significantly related to end-diastolic left ventricular internal diameter (LVIDd) indexed for body area (BSA) (P<0.01). Conclusion. Cardiac TnT does not contribute to the early detection of late onset anthracycline-induced cardiotoxicity. Abnormal levels of NT-pro-BNP were detected in 13% of 122 asymptomatic, long-term Survivors of childhood cancer. Follow-up of these survivors is essential to answer the question whether NT-pro-BNP is an early marker for late onset anthracycline-induced cardiotoxicity. Pediatr Blood Cancer 2009;52:631 636. (C) 2009 Wiley-Liss, Inc.