Doxorubicin‐Induced Cardiomyopathy in Children
Open accessAbstract
Doxorubicin‐induced cardiotoxicity in childhood cancer survivors is a growing problem. The population of patients at risk for cardiovascular disease is steadily increasing, as five‐year survival rates for all types of childhood cancers continue to improve. Doxorubicin affects the developing heart differently from the adult heart and in a subset of exposed patients, childhood exposure leads to late, irreversible cardiomyopathy. Notably, the prevalence of late‐onset toxicity is increasing in parallel with improved survival. By the year 2020, it is estimated that there will be 500,000 childhood cancer survivors and over 50,000 of them will suffer from doxorubicin‐induced cardiotoxicity. The majority of the research to‐date, concentrated on childhood cancer survivors, has focused mostly on clinical outcomes through well‐designed epidemiological and retrospective cohort studies. Preclinical studies have elucidated many of the cellular mechanisms that elicit acute toxicity in cardiomyocytes. However, more research is needed in the areas of early‐ and late‐onset cardiotoxicity and more importantly improving the scientific understanding of how other cells present in the cardiac milieu are impacted by doxorubicin exposure. The overall goal of this review is to succinctly summarize the major clinical and preclinical studies focused on doxorubicin‐induced cardiotoxicity. As the prevalence of patients affected by doxorubicin exposure continues to increase, it is imperative that the major gaps in existing research are identified and subsequently utilized to develop appropriate research priorities for the coming years. Well‐designed preclinical research models will enhance our understanding of the pathophysiology of doxorubicin‐induced cardiotoxicity and directly lead to better diagnosis, treatment, and prevention. © 2019 American Physiological Society.Compr Physiol 9:905‐931, 2019.
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The cumulative anthracycline dose is a major risk factor for severe cardiomyopathy development, but young age at treatment, female sex, peak drug exposure and additional stress to the heart have also been implicated.
“The cumulative anthracycline dose is a major risk factor for severe cardiomyopathy development but young age at treatment, female sex, peak drug exposure and additional stress to the heart have also been implicated 161,162,163 .”
From Osteosarcoma (2022) · cites this paper as [161]
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- Authors
- Mancilla, T. R., Iskra, B., & Aune, G. J.
- Affiliations
- The University of Texas at San Antonio Health Science Center (US)
- Corresponding author
- Aune, Gregory J.
- Venue
- Comprehensive Physiology
- Publisher
- Wiley
- Published
- 2019-06-12
- Volume
- 9
- Issue
- 3
- Pages
- 905-931
- ISSN
- 2040-4603 (ISSN-L)
- PMC
- PMC7000168
- OpenAlex
- W2953223155
- Cited by
- 108
- References
- 361
- Citations by year
- 2026: 3 · 2025: 11 · 2024: 28 · 2023: 21 · 2022: 16 · 2021: 21 · 2020: 5 · 2019: 3
- Type
- other
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Comprehensive physiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (F30AG057213)
- National Institute of General Medical Sciences (T32GM113896)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Chemotherapy-induced cardiotoxicity and mitigation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiomyopathy and Myosin Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- doxorubicin, cardiotoxicity, cardiomyopathy, childhood cancer survivors, cardiomyocytes, cardiac pathophysiology, childhood cancer, cardioprotection
- MeSH terms
- Age Factors, Antibiotics, Antineoplastic, Child, DNA Damage, Doxorubicin, Endothelium, Vascular, Humans, Mitochondria, Heart, Reactive Oxygen Species, Neuregulins, Myocytes, Cardiac, Cardiotoxicity, ErbB Receptors
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