{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:01:39Z","timestamp":1790172099252,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cyclophosphamide (CY) is associated with potentially fatal cardiotoxicity, yet no electrocardiographic indices have been established for early detection of CY\u2010induced cardiomyopathy. This study aimed to determine whether corrected QT interval (QTc) prolongation can predict early onset of CY\u2010related cardiac dysfunction in pediatric patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 62 children who received high\u2010dose CY therapy (\u2265100\u00a0mg\/kg) for hematologic or oncologic diseases between 2010 and 2025. CY\u2010induced cardiomyopathy was defined as a \u226510% reduction in the left ventricular ejection fraction to less than 50% or elevated brain natriuretic peptide\/\n                      <jats:italic>N<\/jats:italic>\n                      \u2010terminal pro\u2010brain natriuretic peptide levels, according to the 2021 International Cardio\u2010Oncology Society criteria. Resting 12\u2010lead ECGs were obtained before and within 24\u00a0h of CY administration. QTc was calculated using the Fridericia and Bazett formulas, and \u0394QTc (post\u2013pre) was evaluated using logistic regression and receiver operating characteristic (ROC) analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven (11.3%) patients developed CY\u2010induced cardiomyopathy. QTc after CY administration and \u0394QTc were significantly greater in the cardiomyopathy group (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). In multivariate analysis, \u0394QTc was independently associated with cardiomyopathy (odds ratio 2.21, 95% confidence interval [CI]: 1.26\u20133.90,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0060). ROC analysis revealed excellent predictive accuracy (area under the curve = 0.96), with a \u0394QTc \u226530.5\u00a0ms yielding 100% sensitivity and 89.1% specificity. Progressive QTc prolongation was also observed from pre\u2010 to post\u2010CY and at diagnosis in the affected patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>QTc prolongation within 24\u00a0h of CY administration suggests subsequent CY\u2010induced cardiomyopathy in children. \u0394QTc may serve as an early, noninvasive marker for timely detection and intervention in CY\u2010induced cardiotoxicity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70102","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T09:21:34Z","timestamp":1768036894000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prolonged Corrected QT Interval as an Early Electrocardiographic Marker of Cyclophosphamide\u2010Induced Cardiotoxicity in Pediatric Hematology and Oncology Patients"],"prefix":"10.1002","volume":"73","author":[{"given":"Junpei","family":"Kawamura","sequence":"first","affiliation":[{"name":"Department of Pediatrics Graduate School of Medical and Dental Sciences Kagoshima University  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Ueno","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Graduate School of Medical and Dental Sciences Kagoshima University  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuro","family":"Nishikawa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Graduate School of Medical and Dental Sciences Kagoshima University  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Graduate School of Medical and Dental Sciences Kagoshima University  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Nakae","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Graduate School of Medical and Dental Sciences Kagoshima University  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Graduate School of Medical and Dental Sciences Kagoshima University  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1991.9.7.1215"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1981.00340060066015"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-019-0509-1"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajco.13674"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12026-009-8149-y"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30534"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-016-2654-6"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab674"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.654"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2020.10.007"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2023.07.006"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2022.04.006"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-09-0979"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.033943"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2014.12.037"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.119.008253"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.03.071"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/6543"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2018.12.018"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0131394"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/toxsci\/kfu233"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjopen\/oeac034"},{"key":"e_1_2_7_24_1","first-page":"369","article-title":"Analysis 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