{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:52:52Z","timestamp":1790707972923,"version":"4.1.0"},"reference-count":79,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T00:00:00Z","timestamp":1609891200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Disease Markers"],"published-print":{"date-parts":[[2021,1,6]]},"abstract":"<jats:p>Ongoing research in the field of pediatric oncology has led to an increased number of childhood cancer survivors reaching adulthood. Therefore, ensuring a good quality of life for these patients has become a rising priority. Considering this, the following review focuses on summarizing the most recent research in anthracycline-induced cardiac toxicity in children treated for leukemia. For pediatric cancers, anthracyclines are one of the most used anticancer drugs, with over half of the childhood cancer survivors believed to have been exposed to them. Anthracyclines cause irreversible cardiomyocyte loss, leading to chronic, progressive heart failure. The risk of developing cardiotoxicity has been known to increase with the treatment-free interval and total cumulative dose. However, because of individual variations in anthracycline metabolism, it has recently been shown that there is no risk-free dose. Moreover, studies have shown that diagnosing anthracycline-induced cardiomyopathy in the symptomatic phase is associated with poor treatment response and prognosis. Thus, early and systematic evaluation of these patients is crucial to allow optimal therapeutic intervention. Although currently echocardiographic assessment of left ventricle ejection fraction and cardiac biomarker evaluation are being used for cardiac function monitoring in oncologic patients, there is no established follow-up and treatment protocol for these patients, and these methods are neither specific nor sensitive for identifying early cardiac dysfunction. All things considered, the need for ongoing research in the field of pediatric cardiooncology is crucial to offer these patients a chance at a good quality of life as adults.<\/jats:p>","DOI":"10.1155\/2021\/8828410","type":"journal-article","created":{"date-parts":[[2021,1,8]],"date-time":"2021-01-08T18:41:01Z","timestamp":1610131261000},"page":"1-9","source":"Crossref","is-referenced-by-count":17,"title":["Cardiotoxicity: A Major Setback in Childhood Leukemia Treatment"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7000-9949","authenticated-orcid":true,"given":"Diana R.","family":"Laz\u0103r","sequence":"first","affiliation":[{"name":"Emergency County Hospital for Children, Pediatric Clinic No. 2, Department of Pediatric Cardiology, Cluj-Napoca, Romania"},{"name":"\u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Department No. 11, Oncology, Cluj-Napoca 400012, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9407-2261","authenticated-orcid":true,"given":"Anca D.","family":"Farca\u015f","sequence":"additional","affiliation":[{"name":"Emergency Clinical County Hospital, Cardiology Department, Cluj-Napoca, Romania"},{"name":"\u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Department No. 5, Internal Medicine, Cluj-Napoca 400012, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4111-1295","authenticated-orcid":true,"given":"Cristina","family":"Blag","sequence":"additional","affiliation":[{"name":"\u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Department No. 9, Mother & Child, Cluj-Napoca 400012, Romania"},{"name":"Emergency County Hospital for Children, Pediatric Clinic No. 2, Department of Hemato-Oncology, Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2237-4164","authenticated-orcid":true,"given":"Alexandra","family":"Neaga","sequence":"additional","affiliation":[{"name":"\u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Department No. 9, Mother & Child, Cluj-Napoca 400012, Romania"},{"name":"Emergency County Hospital for Children, Pediatric Clinic No. 2, Department of Hemato-Oncology, Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9461-987X","authenticated-orcid":true,"given":"Mihnea T.","family":"Zdrenghea","sequence":"additional","affiliation":[{"name":"\u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Department No. 11, Oncology, Cluj-Napoca 400012, Romania"},{"name":"\u201cProf. Dr. Ion Chiricuta\u201d Oncology Institute, Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7535-8766","authenticated-orcid":true,"given":"C\u0103lin","family":"C\u0103inap","sequence":"additional","affiliation":[{"name":"\u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Department No. 11, Oncology, Cluj-Napoca 400012, Romania"},{"name":"\u201cProf. Dr. Ion Chiricuta\u201d Oncology Institute, Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3847-0940","authenticated-orcid":true,"given":"Florin L.","family":"Laz\u0103r","sequence":"additional","affiliation":[{"name":"\u201cNicolae Stancioiu\u201d Heart Institute, Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5574-3969","authenticated-orcid":true,"given":"Adrian","family":"Stef","sequence":"additional","affiliation":[{"name":"\u201cNicolae Stancioiu\u201d Heart Institute, Cluj-Napoca, Romania"},{"name":"\u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Department No. 7, Surgery, Cluj-Napoca 400012, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9500-2372","authenticated-orcid":true,"given":"Simona S.","family":"C\u0103inap","sequence":"additional","affiliation":[{"name":"Emergency County Hospital for Children, Pediatric Clinic No. 2, Department of Pediatric Cardiology, Cluj-Napoca, Romania"},{"name":"\u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Department No. 9, Mother & Child, Cluj-Napoca 400012, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21235"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28748"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4557-2865-7.00096-5"},{"issue":"4","key":"4","first-page":"1269","article-title":"The prognostic role of EBER in pediatric cancer","volume":"56","author":"S. S. C\u0103inap","year":"2015","journal-title":"Romanian Journal of Morphology and Embryology"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30498-4"},{"key":"6","volume-title":"Nelson textbook of pediatrics","author":"R. Kliegman","year":"2016","edition":"20th"},{"key":"7","volume-title":"PDQ Childhood Acute Lymphoblastic Leukemia Treatment","author":"PDQ\u00ae Pediatric Treatment Editorial Board","year":"2019"},{"key":"8","volume-title":"PDQ Childhood Acute Myeloid Leukemia\/Other Myeloid Malignancies Treatment","author":"PDQ\u00ae Pediatric Treatment Editorial Board","year":"2019"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3182a88099"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.4061\/2011\/942090"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djp440"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b4606"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0b013e32835b0b6a"},{"issue":"4","key":"14","doi-asserted-by":"crossref","first-page":"214","DOI":"10.2174\/157340311799960645","article-title":"Anthracycline cardiotoxicity: prevalence, pathogenesis and treatment","volume":"7","author":"M. Volkova","year":"2014","journal-title":"Current Cardiology Reviews"},{"key":"15","article-title":"Late effects of treatment for childhood cancer (PDQ\u00ae): health professional version","volume-title":"PDQ Cancer Information Summaries (Internet)","year":"2019"},{"issue":"3","key":"16","first-page":"568","article-title":"Platinum derivatives: a multidisciplinary approach","volume":"22","author":"S. Gheorghe-Cetean","year":"2017","journal-title":"Journal of BUON"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2005.05.827"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1200\/jco.20.5.1215"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2007.136093"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2016.01.027"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.1021\/tx800002r"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.1007\/s10557-016-6711-0"},{"key":"23","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.1311"},{"key":"24","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2018.01262"},{"key":"25","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.113.000665"},{"key":"26","doi-asserted-by":"publisher","DOI":"10.5772\/33561"},{"key":"27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2006.08.005"},{"key":"28","doi-asserted-by":"publisher","DOI":"10.1016\/j.ppedcard.2014.09.003"},{"key":"29","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31610-0"},{"key":"30","doi-asserted-by":"publisher","DOI":"10.3892\/mco.2019.1854"},{"key":"31","doi-asserted-by":"publisher","DOI":"10.1111\/1440-1681.13036"},{"key":"32","doi-asserted-by":"publisher","DOI":"10.1016\/j.acvd.2012.04.008"},{"key":"33","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14374"},{"key":"34","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.76.3920"},{"key":"35","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.117.246140"},{"issue":"4","key":"36","first-page":"487","article-title":"Chemotherapy-induced cardiotoxicity in oncology \u2013 drugs involved and clinical assessment","volume":"64","author":"S. S. C\u0103inap","year":"2016","journal-title":"Farm\u00e1cia"},{"key":"37","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-06-358226"},{"key":"38","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.34.8987"},{"key":"39","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-00075-1"},{"key":"40","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20352"},{"key":"41","doi-asserted-by":"publisher","DOI":"10.1007\/s00280-016-3174-8"},{"key":"42","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdq200"},{"key":"43","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-015-1096-6"},{"key":"44","doi-asserted-by":"publisher","DOI":"10.1186\/s40959-018-0032-3"},{"key":"45","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.05.021"},{"key":"46","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.04.013"},{"key":"47","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.43.379"},{"key":"48","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPB66LRIIVMQDR"},{"key":"49","doi-asserted-by":"publisher","DOI":"10.1097\/01.hco.0000161832.04952.6a"},{"key":"50","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/7583690"},{"key":"51","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2005.050153"},{"key":"52","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.12.063"},{"key":"53","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdi152"},{"key":"54","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2010.04.002"},{"key":"55","doi-asserted-by":"publisher","DOI":"10.2147\/VHRM.S89842"},{"key":"56","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2018.08.035"},{"issue":"7","key":"57","first-page":"122","article-title":"The role of biomarkers and echocardiography in the evaluation of cardiotoxicity risk in children treated for leukemia","volume":"23","author":"D. R. Maniu","year":"2018","journal-title":"Journal of BUON"},{"issue":"5","key":"58","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1542\/peds.89.5.942","article-title":"Guidelines for cardiac monitoring of children during and after anthracycline therapy: report of the Cardiology Committee of the Childrens Cancer Study Group","volume":"89","author":"J. J. Steinherz","year":"1992","journal-title":"Pediatrics"},{"key":"59","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw211"},{"key":"60","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.016704"},{"key":"61","doi-asserted-by":"publisher","DOI":"10.1124\/pr.56.2.6"},{"key":"62","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-0727"},{"key":"63","doi-asserted-by":"publisher","DOI":"10.1159\/000455823"},{"issue":"4","key":"64","first-page":"691","article-title":"Optimizing liposomes for delivery of chemotherapeutic agents to solid tumors","volume":"51","author":"D. C. Drummond","year":"1999","journal-title":"Pharmacological Reviews"},{"key":"65","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbamem.2015.01.003"},{"key":"66","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djv357"},{"key":"67","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70204-7"},{"key":"68","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.60.8851"},{"key":"69","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.02.3879"},{"key":"70","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.11.8778"},{"key":"71","unstructured":"European Medicines AgencyAssessment report dexrazoxane-containing medicinal products2020http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/Referrals_document\/Dexrazoxane_31\/WC500120340.pdf.Accessed"},{"key":"72","article-title":"Questions and answers on Cardioxane","author":"European Medicines Agency","year":"2020"},{"key":"73","doi-asserted-by":"publisher","DOI":"10.1590\/1806-9282.64.08.745"},{"key":"74","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.07.052"},{"key":"75","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21840"},{"key":"76","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw022"},{"key":"77","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.02.072"},{"key":"78","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.196"},{"key":"79","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.635144"}],"container-title":["Disease Markers"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/dm\/2021\/8828410.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/dm\/2021\/8828410.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/dm\/2021\/8828410.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,11]],"date-time":"2022-12-11T01:35:49Z","timestamp":1670722549000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/dm\/2021\/8828410\/"}},"subtitle":[],"editor":[{"given":"Marcello","family":"Ciaccio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,1,6]]},"references-count":79,"alternative-id":["8828410","8828410"],"URL":"https:\/\/doi.org\/10.1155\/2021\/8828410","relation":{},"ISSN":["1875-8630","0278-0240"],"issn-type":[{"value":"1875-8630","type":"electronic"},{"value":"0278-0240","type":"print"}],"subject":[],"published":{"date-parts":[[2021,1,6]]}}}