Nearly one-third of children with a hematologic malignancy developed moderate to severe cardiotoxicity within 1 year of their cancer diagnosis, according to the results of an ongoing study presented at the EHA 2022 Hybrid Congress.

Given that cardiotoxicity is a serious adverse event associated with anticancer treatment, researchers aimed to evaluate the acute and early onset of cardiotoxicity and associated outcomes in a pediatric population.

The prospective study included 47 pediatric patients with hematologic malignancies and early cardiotoxicity between 2018 and 2021. Cardiotoxicity was defined as an ejection fraction below 50% or a reduction in ejection fraction greater than 10% from diagnosis, electrophysiologic dysfunction, or abnormal ultrasound, clinical, or enzymatic findings.

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At baseline, the patients’ median age was 8 years (range, 2.5-16), and 64% of patients were male. Malignancies included acute lymphoblastic leukemia, acute myeloid leukemia, chronic myeloid leukemia, and lymphoma.

Of the 47 patients, 44 had normal test values at baseline. Forty-five patients received anthracyclines, with a total dose less than 360 mg/m2. None of the patients underwent radiation.

Cardiotoxicity was seen in 30% of evaluable patients (13/44). Two patients developed cardiotoxicity after their first cycle of chemotherapy, and the remaining 11 patients developed cardiotoxicity within 1 year of diagnosis.

Five patients (10%) received treatment with an ACE inhibitor or beta-blocker. All 13 patients recovered during a 1-week to 2-month period.

Most patients were able to continue chemotherapy at the full dose. There were 2 cases of dose delay and 1 case of dose reduction to one-third of the starting dose.

“The preliminary results of our ongoing study show that moderate or severe cardiotoxicity occurred in 30% of patients with hematologic malignancies within the first year of diagnosis,” the study authors wrote.

Disclosures are not available for this presentation.


Antoniadi K, Kelaidi C, Tzotzola V, et al. Early appearance of cardiotoxicity in children with hematological malignancies (HM). Presented at EHA 2022; June 9-12, 2022. Abstract P1700.