Evaluation of Cardiac Function in Children with Solid Tumors, who Underwent Tandem High-Dose Chemotherapy and Autologous Stem Cell Transplantation / 임상소아혈액종양

ABSTRACT

BACKGROUND: Even though the five year survival rate and prognosis of childhood solid tumors have been improved through the introduction of dose-escalation using tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/auto-SCT), changes in cardiac function have not yet been studied. We therefore evaluated cardiac function after tandem HDCT/auto-SCT. METHODS: This study retrospectively analyzed 56 pediatric patients who were diagnosed with solid tumors and who underwent tandem HDCT/auto-SCT at Samsung Medical Center. We investigated the cardiac function of these patients using echocardiography to evaluate the parameters of the left ventricular ejection fraction, e/e', and left ventricular Tei index. RESULTS: The mean left ventricular ejection fraction, e/e', and left ventricular Tei index at one year after the second HDCT/auto-SCT were 65.7%, 0.32, and 8.6, respectively. When compared those with before the first tandem HDCT/auto-SCT, there were no significant negative changes. We evaluated the changes in cardiac function in different subgroups, based on doxorubicin, radiotherapy involving heart, and the age of the patient at diagnosis. There were no significant changes of cardiac function after the treatment in any of the subgroups. Clinical heart failure did not develop in any of the patients. CONCLUSION: This study showed no significant negative changes in cardiac function at one year after tandem HDCT/auto-SCT. However, long-term follow-up studies of cardiac function in survivors and further studies of cardiac function are needed.