Anthracycline-induced Cardiac Toxicity More Likely in Underweight Childhood Cancer Survivors

Background: We did a retrospective medical record and echocardiogram review of patients with history of anthracyclines and/or radiation seen in a long-term survivor clinic from 2000-2007. Observations: Three hundred eight out of three hundred seventy (83.2%) patients had received at least 1 screening echocardiogram, and 24/308 (7.8%) patients had an abnormal echocardiogram. Observed risk factors for a future abnormal echocardiogram included anthracycline dose >= 250mg/m(2) and underweight status (BMI < 5th%) at follow-up. Age, gender, radiation, anthracycline type, history of relapse, and history of stem cell transplant were not risk factors. Conclusions: Our results confirm the dose-dependent risk of anthracyclines, and describe a novel association with underweight status.