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Pozne posledice zdravljenja z antraciklini na srcu otrok z levkemijo
Valenšek-Prestor, Veronika
Multidrug chemoterapy, including antracycline antibiotics, used in the treatment of acute lymphoblastic or myeloblastic leukemia, is correlated with heart toxicity. Their use is limited by toxic ...cardiomyopathy. The most seriousside effect of antracyclines is cardiomyopathy followed by congestive heart failure. Several risk factors such as gender, age at diagnosis, cumulative dose, single dose, application mode, previous or concomitant mediastinal radiotherapy, combination therapy with alkylating agents and time of follow up contribute to the developement of antracycline-induced cardiomyopathy. In a retrospective study in cooperation with the Clinical department of Cardiovascular diseases of Medical Centre in Ljubljana the influence of antracyclines therapy and of the above cited risk factors was analysed. The aim of our study was further to define the most suitable method for detection late cardiac toxicity caused by antracyclines. Fourty-six patients, 2-17 years old at diagnosis, treated for leukemia beetwen 1968 and 1992 at the hematooncological department of Children's Hospital and the Oncological Institute in Ljubljana were included in the study. The time of follow up was 5-23 years (mean 16 years). Thirty-four patients received a cumulative dosis of antracycline between 50 and 540 mg/m2 (mean 203 mg/m2), 11of these had also alkylafing agents and 12 were not treated with antracyclines (control group). The methods of evaluation of cardiac performance included: clinical history, physical examination, electrocardiogram (ECG), electrocardiographic exercise testing on a bicycle ergometer and echocardiographic examination. For statistical analysis the Chi2test and the T test were used. The results of our study showed that exercise tolerance was below the predicted values in 23 (50 %) of all patients. In 21 (46 %) patients ECG abnormalities were found. (Abstract truncated at 2000 characters.)
Type of material - master's thesis
Publication and manufacture - Ljubljana : [V. Velenšek Prestor], 1999
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