The world’s first international clinical guidelines to help prevent and treat cardiac complications in children undergoing cancer treatment have been created.
The guidelines, published in JACC : Advancescover the evaluation, screening and follow-up of cardiovascular diseases, for pediatric patients receiving cancer treatment with new molecular therapies, immunotherapy, chemotherapy and radiotherapy.
The expert consensus, led by researchers at the Murdoch Children’s Research Institute, defined the high-risk group of cancer patients who should undergo cardiac workup, standardized an approach to screening and monitoring during treatment, and provided recommendations to protect vulnerable young hearts. .
Murdoch Children’s Associate Professor Rachel Conyers said that although international guidelines for monitoring poor cardiac side effects during treatment exist for adult patients, none were specific to children.
Associate Professor Conyers said the success of new cancer drugs has increased the risk of cardiac side effects which occur at the start of treatment, sometimes within days, warranting closer monitoring of heart health and a earlier monitoring.
“Recent advances in the treatment of childhood cancer have resulted in survival rates of over 80%. However, improving serious health outcomes in survivors remains an important and critical goal and prevention is key,” she said.
“Heart complications are the leading cause of death among childhood cancer survivors, second only to cancer relapse. Modern treatments, including precision medicine, have expanded the agents that can cause heart problems.”
Childhood cancer survivors are 15 times more likely to have heart failure and eight times more likely to have heart disease than the general population.
Associate Professor Conyers said the guidelines would be an indispensable tool for clinicians to significantly reduce the harmful impact of cancer drugs on children’s hearts.
“The guidelines are a major step forward for the field of cardio-oncology as previously there was no defined approach for surveillance or follow-up of pediatric patients during treatment despite new therapies having early cardiac complications such as high blood pressure, abnormal heartbeats and heart failure. ,” she says.
The Australian and New Zealand expert panel was made up of pediatric and adult cardiologists and pediatric oncologists who undertook a Delphi consensus approach across 11 areas of cardio-oncology care. The Australian New Zealand Children’s Oncology Group endorsed the study with useful guidelines for all tertiary institutes treating pediatric oncology patients or initiating cardio-oncology clinics.
