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Letiția Elena Radu, Andra Beldiman, Ioana Ghiorghiu, Alina Oprescu, Constantin Arion and Anca Coliță
The international standard protocol for acute lymphoblastic leukaemia (ALL), the most common haemato-oncological pathology at paediatric age, uses anthracyclines as antitumor agents, potentially associated with early or late onset cardiac damage. Currently, echocardiography is the gold standard in the diagnosis of cardiotoxicity, but several biomarkers are evaluated as a possible replacement, pending more extensive clinical studies. We started a prospective study in order to determine the role of two biomarkers, troponin and heart-type fatty acid binding protein, in the evaluation of cardiotoxicity in children over one year of age, diagnosed with ALL. Between February 2015 and April 2016, 20 patients were enrolled and monitored at diagnosis, during chemotherapy and four months after the end of reinduction, through cardiac evaluation and dosing of those two markers in five different points of the treatment protocol. During the first year of follow-up, the patients did not develop clinical signs of cardiac damage, but the study showed a slight increase in troponin levels during chemotherapy, with the return to baseline value after treatment cessation, and also a correlation with the total dose of anthracyclines given to the patient. On the other hand, the second biomarker, heart-type fatty acid binding protein, did not seem to be useful in detecting subclinical cardiac damage in these patients.
Vladimir Gasic, Biljana Stankovic, Branka Zukic, Dragana Janic, Lidija Dokmanovic, Nada Krstovski, Jelena Lazic, Goran Milosevic, Marianna Lucafò, Gabriele Stocco, Giuliana Decorti, Sonja Pavlovic and Nikola Kotur
Among pediatric malignancies, acutelymphoblasticleukemia (ALL) is the most common hematological and overall malignancy, contributing to 30% of diagnosed cancers and around 80% of all pediatric leukemias. Pediatric ALL is a malignancy with one of the highest cure rates, achieved by treating the patients with the internationally recognised treatment protocols like the Berlin-Frankfurt-Munster (BFM) protocol ( 1 , 2 , 3 ). Risk stratification of ALL is para mount in choosing the effective treatment strategy. Hence, risk stratification is already
Laurenţiu Lucaci, Ștefana Maria Moisă, Marin Burlea and Lucian Miron
. Long-term results of NOPHO ALL-92 and ALL-2000 studies of childhood acutelymphoblasticleukemia. Leukemia. 2010;24(2):345-54. DOI: 10.1038/leu.2009.251
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Patrycja Sujka-Kordowska, Agnieszka Malińska and Maciej Zabel
and myelodysplastic syndromes. Blood 2000; 96(6): 2240-2245.
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Marcelina Kaleta, Joanna Zawitkowska, Jerzy R. Kowalczyk and Tomasz Olcha
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