{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T11:40:10Z","timestamp":1756208410398,"version":"3.44.0"},"reference-count":21,"publisher":"Wiley","issue":"16","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Long\u2010term childhood cancer survivors (CCS) may develop anthracycline\u2010induced cardiomyopathy. Our cross\u2010sectional study focused on the question of whether a central echocardiographic reference assessment is associated with a higher detection rate of cardiac dysfunction in a population\u2010based cohort of affected children with neuroblastoma or nephroblastoma. We also examined the prevalence of anthracycline\u2010induced cardiomyopathy and its risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Patients<\/jats:title><jats:p>The cohort of this subproject comprises 370 nephroblastoma or neuroblastoma survivors diagnosed with cancer between 1990 and 2012. At study entry, participants were younger than 18\u2009years old, had been treated with anthracyclines, and had no documented previous cardiac disease. Data were collected via patient questionnaires, cardiologic examinations in the network of adults with congenital heart defects (Erwachsene mit angeborenem Herzfehler [EMAH]) and a reference assessment of the recorded echocardiography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of cardiomyopathy in the study cohort (mean age: 12\u2009years) was 6.3% at a median of 9.1\u2009years after initial cancer diagnosis. Risk factors were an age under 5\u2009years at tumor diagnosis and concomitant treatment with cyclophosphamide or radiation. As a central and novel finding, the detection rates by the EMAH cardiologists and the reference center are similarly high but discrepant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Limitations were mainly due to the low responder rate and incomplete data. This study established a nationwide competence network linking pediatric oncology and cardiology centers across six university hospitals in Germany, enabling data collection on pediatric CCS. Despite lower case numbers compared to adult CCS cohorts, meaningful data were gathered and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Cardiac late effects after anthracycline\u2010based therapy in childhood affect a relevant proportion of long\u2010term CCS at pediatric age. In order to enable timely diagnosis and treatment, preventive examinations are essential and might benefit from additional central reference assessments. Discrepancy in detection of cardiomyopathy by reference and EMAH cardiologists requires further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.71158","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T10:00:28Z","timestamp":1755684028000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anthracycline\u2010Induced Cardiomyopathy After Nephro\u2010\/Neuroblastoma in Childhood: The Importance of Cardiological Reference Assessment"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3672-2619","authenticated-orcid":false,"given":"Kristina","family":"Kleen","sequence":"first","affiliation":[{"name":"Paediatric Haematology and Oncology, Department of Paediatrics and Adolescent Medicine University Hospital Schleswig\u2010Holstein  L\u00fcbeck 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Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Zolk","sequence":"additional","affiliation":[{"name":"Institute for Clinical Pharmacology Immanuel Clinic R\u00fcdersdorf, Brandenburg Medical School  R\u00fcdersdorf Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"Graf","sequence":"additional","affiliation":[{"name":"Paediatric Haematology and Oncology University Hospital Homburg\/Saar  Homburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hashim","family":"Abdul\u2010Khaliq","sequence":"additional","affiliation":[{"name":"Paediatric Cardiology University Hospital Homburg\/Saar  Homburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thorsten","family":"Langer","sequence":"additional","affiliation":[{"name":"Paediatric Haematology and Oncology, Department of Paediatrics and Adolescent Medicine University Hospital Schleswig\u2010Holstein  L\u00fcbeck 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