{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:01:42Z","timestamp":1777942902172,"version":"3.51.4"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"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":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A routine baseline echocardiogram is often obtained prior to anthracycline administration in children with cancer. The utility of baseline echocardiogram is unclear in patients with standard risk B\u2010cell acute lymphoblastic leukemia (SR B\u2010ALL) as their anthracycline cumulative dose is low. We performed a quality improvement project to understand the clinical utility of routine pre\u2010anthracycline echocardiograms in patients with SR B\u2010ALL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed baseline echocardiogram results for all children with SR B\u2010ALL treated at a single center from 2011 to 2024. Echocardiographic findings, including any significant structural or functional abnormalities, and the impact of echocardiogram results on anthracycline administration were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 286 patients with a median age at diagnosis of 4.13 years [IQR 2.92\u20135.52] were included. Abnormal echocardiographic findings were reported in six patients (2.1%), but mainly represented incidental findings with only one patient requiring cardiology follow\u2010up for a bicuspid aortic valve. No echocardiogram identified reduced cardiac function or any finding that altered or delayed anthracycline administration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A routine baseline echocardiogram in patients with SR B\u2010ALL prior to anthracycline administration is without clear utility. Based on these results, a change in practice was implemented in our institution to discontinue routine pre\u2010anthracycline echocardiograms for this population. Omitting this low\u2010value test may reduce unnecessary discomfort in children, family worry, and health\u2010care\u2010related costs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70265","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T08:28:52Z","timestamp":1773908932000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of the Utility of Baseline Echocardiogram in Patients With Standard Risk Precursor B\u2010Lymphoblastic Leukemia"],"prefix":"10.1002","volume":"73","author":[{"given":"Ziyad","family":"Alrajhi","sequence":"first","affiliation":[{"name":"Division of Haematology\/Oncology The Hospital for Sick Children University of Toronto  Toronto Ontario Canada"},{"name":"Department of Pediatrics University of Toronto  Toronto Ontario Canada"},{"name":"Department of Pediatric Hematology and Oncology King Faisal Specialist Hospital and Research Center  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Pozza","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Toronto  Toronto Ontario Canada"},{"name":"Division of Cardiology, The Labatt Family Heart Centre, The Hospital for Sick Children University of Toronto  Toronto Ontario Canada"},{"name":"Paediatric Cardiology Unit, Department of Women's and Children's Health University of Padua  Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luc","family":"Mertens","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Toronto  Toronto Ontario Canada"},{"name":"Division of Cardiology, The Labatt Family Heart Centre, The Hospital for Sick Children University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8300-3095","authenticated-orcid":false,"given":"Adam Paul","family":"Yan","sequence":"additional","affiliation":[{"name":"Division of Haematology\/Oncology The Hospital for Sick Children University of Toronto  Toronto Ontario Canada"},{"name":"Department of Pediatrics University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Alexander","sequence":"additional","affiliation":[{"name":"Division of Haematology\/Oncology The Hospital for Sick Children University of Toronto  Toronto Ontario Canada"},{"name":"Department of Pediatrics University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"\u201cNccr*Explorer: An Interactive Website for Nccr Cancer Statistics \u201d National Cancer Institute last updated September 26 2024 https:\/\/nccrexplorer.ccdi.cancer.gov."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102006\u201001\u2010024729"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1400972"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2009.07.003"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2022.10.029"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1470\u20102045(23)00012\u20108"},{"key":"e_1_2_9_8_1","unstructured":"\u201cLong\u2010Term Follow\u2010Up Guidelines for Survivors of Childhood Adolescent and Young Adult Cancers \u201d Children's Oncology Group 2024 http:\/\/www.survivorshipguidelines.org."},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2023.09.009"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2023.11.015"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/circimaging.124.017944"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdr595"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.23066"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.26481"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs\u20102015\u2010004070"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1200\/op.22.00130"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.04.024"},{"key":"e_1_2_9_18_1","unstructured":"Ministry of Health Schedule of Benefits: Physician Services under the Health Insurance Act (2025)Ontario Menistry of Health https:\/\/www.ontario.ca\/files\/2026\u201301\/moh\u2013schedule\u2013benefit\u20132025\u201301\u201302.pdf."}],"container-title":["Pediatric Blood &amp; 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