ABSTRACT

Antracyclines have been used for a wide variety of childhood solid tumors. Doxorubicin is the most common one used in pediatric oncology. Dose dependent cardiotoxicity is the major adverse effect of doxorubicin and may appear months or years after therapy. Serum BNP levels have been reported to have correlation with left ventricular dysfunction and may be used as a marker for doxorubicin-induced cardiotoxicity. In this study, we detected cardiac functions of 22 children with solid tumors who had received cumulative doxorubicin doses of 120-450 mg/m2 by echocardiography and detected the serum BNP levels. A correlation between serum BNP levels and cumulative doxorubicin dose was investigated. Serum BNP levels were found in the range of 0.70-3.00 ng/ml (mean; 1.34 ng/ml). The serum BNP levels in 10 children treated cumulative doxorubicin doses ≥ 420 mg/m2, and in 12 children treated with cumulative doxorubicin levels between 120 and 360 mg/m2 were in the range of 0.80-3.00 ng/ml (mean; 1.67 ng/ml) and 0.70-2.80 ng/ml (mean; 1.37 ng/ml) respectively. No correlation was found between the two groups. However, it was concluded that it is necessary to increase number of the patients enrolled to the study and follow-up the cardiac functions. The patients who have serum BNP concentrations above the mean levels of their groups should be closely followed up to define the potential role of blood BNP level to predict anthracycline-induced cardiotoxicity in survivors of childhood cancer.