Recommendations for cardiomyopathy surveillance for survivors of childhood cancer: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group

Saro H. Armenian, Department of Population Sciences, City of Hope, Duarte, USA. Electronic address: sarmenian@coh.org.Follow
Melissa M. Hudson, Departments of Oncology and Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA.
Renee L. Mulder, Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Centre, Amsterdam, Netherlands.
Ming Hui Chen, Department of Pediatrics, Boston Children's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Louis S. Constine, Departments of Radiation Oncology and Pediatrics, University of Rochester Medical Center, Rochester, NY, USA.
Mary Dwyer, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia.
Paul C. Nathan, The Hospital for Sick Children and the University of Toronto, Department of Pediatrics and Institute of Health Policy, Management and Evaluation, Toronto, ON, Canada.
Wim J. Tissing, Division of Pediatric Oncology and Pediatric Hematology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
Sadhna Shankar, Division of Oncology, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC, USA.
Elske Sieswerda, Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Centre, Amsterdam, Netherlands.
Rod Skinner, Department of Paediatric and Adolescent Haematology/Oncology, Great North Children's Hospital and University of Newcastle, Newcastle upon Tyne, UK.
Julia Steinberger, Department of Pediatrics, Division of Cardiology, University of Minnesota Amplatz Childrens' Hospital, Minneapolis, MN, USA.
Elvira C. van Dalen, Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, the Netherlands.
Helena van der Pal, Department of Pediatric Oncology and Medical Oncology, Emma Children's Hospital/Academic Medical Centre, Amsterdam, Netherlands.
W Hamish Wallace, Department of Hematology/Oncology, Royal Hospital for Sick Children, Edinburgh, Scotland.
Gill Levitt, Department of Oncology/Haematology, Great Ormond Street Hospital for Children NHS Trust, London, UK.
Leontien C. Kremer, Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Centre, Amsterdam, Netherlands.

Abstract

Survivors of childhood cancer treated with anthracycline chemotherapy or chest radiation are at an increased risk of developing congestive heart failure. In this population, congestive heart failure is well recognised as a progressive disorder, with a variable period of asymptomatic cardiomyopathy that precedes signs and symptoms. As a result, several clinical practice guidelines have been developed independently to help with detection and treatment of asymptomatic cardiomyopathy. These guidelines differ with regards to definitions of at-risk populations, surveillance modality and frequency, and recommendations for interventions. Differences between these guidelines could hinder the effective implementation of these recommendations. We report on the results of an international collaboration to harmonise existing cardiomyopathy surveillance recommendations using an evidence-based approach that relied on standardised definitions for outcomes of interest and transparent presentation of the quality of the evidence. The resultant recommendations were graded according to the quality of the evidence and the potential benefit gained from early detection and intervention.

Publication Title

The Lancet. Oncology

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