Table 2 Characteristics of included studies assessing prevalence and incidence of cardiac electrical abnormalities
Authors | Study design | Study aims | Demographics and baseline characteristics | Cancer characteristics |
|---|---|---|---|---|
Bertrand et al., 2021 [50] | Cross-sectional study | To examine heart rate response during a maximal cardiopulmonary exercise test | Participants (N = 216) Eligible for review N = 216 (51.4% males) Age at cardiac evaluation (years) mean ± SD: 22.0 ± 6.4 median (range): 22.0 (8.0—40.0) Geographical region: Canada Socio-economic status: Not reported* Ethnicity: French-Canadian descent Comorbidities: Not reported* | Period of diagnosis: 1987—2010 Age at cancer diagnosis (years) mean ± SD: 6.4 ± 4.7 median (range): 4.0 (0.9—18.0) Time since the end of cancer treatment: minimum 5 years Length of follow-up: N/A Cancer treatment and absolute cumulative dosage Anthracycline chemotherapy (doxorubicin) (N = 216) mean ± SD: 85.4 ± 121.7 mg/m2 median (range): 230.9 (43.6—472.9) mg/m2 Cranial radiotherapy (N = 123) no dosage specified Cardioprotective treatment: Dexrazoxane (N = 65) |
Brouwer et al., 2007 [51] | Cross-sectional study | To re-assesses cardiac status at a very long follow-up of median 22 years post treatment in a subset of the earlier studied survivors | Participants (N = 23) Eligible for review N = 23 (39.1% males) Age at cardiac evaluation (years) median (range): 29.0 (24.0—39.0) Geographical region: Netherlands Socio-economic status: Not reported* Ethnicity: Not reported Comorbidities: Not reported* | Period of diagnosis: Not reported Age at cancer diagnosis (years) median (range): 5.0 (2.0—14.0) Time since the end of cancer treatment (years) median (range): 22.0 (19.5—24.5) Length of follow-up: N/A Cancer treatment and absolute cumulative dosage Induction treatment (6 weeks) Anthracycline (daunorubicin) (N = 13): 100 mg/m2/week Vincristine: 6 × 2 mg/m2/week Prednisone: 28 × 40 mg/m2/day L-Asparaginase: 14 × 200 E/kg/day (weeks 4–6) Central nervous system prophylaxis (2.5–3 weeks) Cranial radiotherapy (N = 23): median (range): 25 (18—25) Gy Methotrexate: 12.5 mg/m2 (maximum 15 mg/m2) Prednisone: 5 × 12.5 mg/m2 Maintenance and consolidation phase (until 2 years from start of treatment) 6-mercaptopurine: 50 mg/m2/day for 5 weeks Alternating with 2 weeks: Methotrexate: 30 mg/m2/week OR Vincristine: 2 mg/m2/week Prednisone: 40 mg/m2/day Cardioprotective treatment: Not reported |
Halazun et al., 1974 [52] | Randomized controlled trial | To describe the evidence to support the occurrence of cardiotoxicity from daunorubicin | Participants (N = 172) Eligible for review N = 172 (58.1% males) Age at cardiac evaluation: Not reported Geographical region: France, USA Socio-economic status: Not reported* Ethnicity: Not reported* Comorbidities: Not reported* | Period of diagnosis: 1968–1971 Age at cancer diagnosis: Not reported Time since the end of cancer treatment: median: 79 days range: 14–280 days Length of follow-up: Not reported Cancer treatment and absolute cumulative dosage Anthracycline chemotherapy (daunorubicin) mean: 780 mg/m2 range: 360–1260 mg/m2 Methotrexate no dosage specified L-Asparaginase no dosage specified Vincristine no dosage specified Prednisone no dosage specified Cardioprotective treatment: Not reported |
Hau Eva et al., 2019 [53] | Case control study | To compare the risk of cardiovascular disease reported by acute lymphoblastic leukemia survivors to that of their siblings, and changes in risk based on the calendar period of diagnosis. It also examines treatment-related risk factors for cardiovascular disease | Participants (N = 511) Eligible for review N = 511 (50.5% males) Age at cardiac evaluation (years) range 16—20 (N = 135) range 21—30 (N = 251) range 31—40 (N = 107) range 41 or more (N = 18) Geographical region: Swiss Socio-economic status: Not reported* Ethnicity: Not reported Comorbidities: Not reported* | Period of diagnosis: 1976—2005 Age at cancer diagnosis (years) (range): (0—19) Time since the end of cancer treatment: minimum 5 years Length of follow-up: N/A Cancer treatment and absolute cumulative dosage Anthracycline (N = 315): no dosage specified Radiotherapy (N = 151): no dosage specified Chest radiotherapy (N = 23): no dosage specified Hematopoietic stem cell transplantation (N = 23) Cardioprotective treatment: Not reported |
Lipshultz et al., 1991 [3] | Cross-sectional study | To evaluate cardiac status in children 1 to 15 years after the successful treatment of acute lymphoblastic leukemia with chemotherapeutic regimens that included doxorubicin | Participants (N = 115) Eligible for review N = 115 (50.4% males) Age at cardiac evaluation (years) mean: 13.6 median (range): 12.6 (3.9—31.7) Geographical region: USA Socio-economic status: Not reported* Ethnicity: Not reported Comorbidities: Not reported* | Period of diagnosis: 1972—1987 Age at cancer diagnosis mean: 6.3 years median (range): 4.8 years (7 months—19.1 years) Time since the end of cancer treatment (years) minimum one median (range): 6.4 (1.0—15.0) Length of follow-up: N/A Cancer treatment and absolute cumulative dosage Anthracycline (doxorubicin) (N = 18): 45 mg/m2 Anthracycline (doxorubicin) (N = 97): median (range): 360 (228–550) mg/m2 Vincristine: no dosage specified Methotrexate: no dosage specified Prednisone: no dosage specified Mercaptopurine: no dosage specified l-asparaginase: no dosage specified Cardioprotective treatment: Not reported |
Pihkala et al., 1994 [49] | Cohort study | To evaluate the long-term effects of bone marrow transplant on myocardial function in children | Participants (N = 30) Eligible for review N = 9 (44.4% males) Age at cardiac evaluation: Not reported Geographical region: Finland Socio-economic status: Not reported* Ethnicity: Not reported Comorbidities: Not reported* | Period of diagnosis: Not reported Age at cancer diagnosis: Not reported Time since the end of cancer treatment (years) mean ± SD: 5.5 ± 3.3 median (range): 5.9 (0.5–9.6) Length of follow-up: N/A Cancer treatment and absolute cumulative dosage Anthracycline chemotherapy (N = 9) mean ± SD: 174.4 ± 87.6 mg/m2 median (range): 140 (120—400) mg/m2 Total body irradiation (N = 9) mean ± SD: 1110.0 ± 101.7 cGy median (range): 1200 (970—1200) cGy Cyclophosphamide (N = 6): no dosage specified Cytosine arabinoside (N = 3): no dosage specified Allogenic bone marrow transplantation (N = 9) Cardioprotective treatment: Not reported |
Velensek Prestor et al., 2000 [17] | Cross-sectional study | To analyze the influence of risk factors to anthracycline cardiotoxicity and to define the most suitable method of late cardiac toxicity detection | Participants (N = 46) Eligible for review N = 46 (37.8% males) Age at cardiac evaluation (years) mean: 23.0 range: 18.0—33.0 Geographical region: Slovenia Socio-economic status: Not reported* Ethnicity: Not reported Comorbidities: Not reported* | Period of diagnosis: 1968—1992 Age at cancer diagnosis (years) mean: 7.0 range: 2.0—17.0 Time since the end of cancer treatment: minimum 5 years mean: 16 range: 5—23 Length of follow-up: N/A Cancer treatment and absolute cumulative dosage Anthracycline chemotherapy (N = 34) mean: 203.0 mg/m2 range: 50.0—540.0 Cranial radiotherapy (N = 46) range: 12—24 Gy AA-cyclophosphamide (N = 9): 3 × 1000 mg/m2 AA-cyclophosphamide (N = 1): 2 × 600 mg/m2 AA-cyclophosphamide (N = 3): 8400 mg/m2 Vincristine: no dosage specified Methotrexate: no dosage specified Prednisone: no dosage specified Mercaptopurine: no dosage specified l-asparaginase: no dosage specified Cytarabine: no dosage specified Thioguanine: no dosage specified Cardioprotective treatment: Not reported |
Rammeloo et al., 2000 [54] | Randomized control trial | To investigate late cardiotoxicity in childhood acute lymphoblastic leukemia survivors after induction treatment with or without daunorubicin | Participants (N = 90) Eligible for review N = 90 (44.4% males) Age at cardiac evaluation (year) Group A: median (range): 18.6 (14.7—31.3) Group B: median (range): 20.1 (14.8—30.0) Geographical region: Netherlands Socio-economic status: Not reported* Ethnicity: Not reported Comorbidities: Not reported* | Period of diagnosis: 1979—1984 Age at cancer diagnosis (years) median (range): 4.5 (1.2—14.9) Time since the end of cancer treatment (years) median (range): 14.8 (11.4—17.8) Length of follow-up: N/A Cancer treatment and absolute cumulative dosage Vincristine (N = 90): no dosage specified Prednisone (N = 90): no dosage specified Asparaginase (N = 90): no dosage specified Anthracycline (daunorubicin) (N = 50, group B): 100 mg/m2 Cardioprotective treatment: Not reported |
Shimomura et al., 2011 [55] | Cross-sectional study | To evaluate Pirarubicin-induced late cardiotoxicity for asymptomatic children who received THP therapy in three consecutive JCCLSG studies (ALL911/ALL941/ALL2000) | Participants (N = 61) Eligible for review N = 61 (49.2% males) Age at cardiac evaluation (years) mean ± SD: 14.7 ± 3.5 median (range): 14.7 (7.6—25.7) Geographical region: Japan Socio-economic status: Not reported* Ethnicity: Not reported Comorbidities: Not reported* | Period of diagnosis: 1991–2003 Age at cancer diagnosis (years) mean ± SD: 5.7 ± 3.5 Time since the end of cancer treatment (years) mean ± SD: 7.2 ± 2.8 median (range): 8.1 (1.7—12.5) Length of follow-up: N/A Cancer treatment and absolute cumulative dosage Anthracycline (Pirarubicin (tetrahydropyranyl-adriamycin)) mean ± SD: 299 ± 192 mg/m2 median (range): 180 (120—740) mg/m2 Anthracycline chemotherapy (doxorubicin and Pirarubicin) mean ± SD: 346 ± 206 mg/m2 median (range): 207 (135—812) mg/m Cardioprotective treatment: Not reported |
Steinherz et al., 1995 [48] | Cross-sectional study | To describe the clinical course, evolution of cardiac findings, and treatment of our symptomatic patients | Participants (N = 15) Eligible for review N = 2 (50% males) Age at cardiac evaluation: Not reported Geographical region: USA Socio-economic status: Not reported* Ethnicity: Not reported Comorbidities: Not reported* | Period of diagnosis: Not reported Age at cancer diagnosis: Not reported Time since the end of cancer treatment: 12 and 19 years Length of follow-up: N/A Cancer treatment and absolute cumulative dosage Anthracycline (daunorubicin) (N = 1): 795 mg/m2 Anthracycline (doxorubicin) (N = 1): 350 mg/m2 Cardioprotective treatment: Not reported |
Turner-Gomes et al., 1996 [56] | Cross-sectional study | To assess cardiopulmonary status and exercise capacity after successful treatment | Participants (N = 19) Eligible for review N = 19 (47.4% males) Age at cardiac evaluation (years) mean ± SD: 13.0 ± 3.5 median (range): 12.3 (7.7—23.8) Geographical region: USA Socio-economic status: Not reported* Ethnicity: Not reported Comorbidities: Not reported* | Period of diagnosis: 1984—1990 Age at cancer diagnosis (years) mean ± SD: 6.1 ± 4.3 median (range): 4.6 (1.5—17.7) Time since the end of cancer treatment (years) Minimum one mean ± SD: 4.6 ± 1.5 median (range): 4.4. (1.1—7.1) Length of follow-up: N/A Cancer treatment and absolute cumulative dosage Anthracycline (doxorubicin): (N = 7 standard risk) mean ± SD: 50 ± 21 mg/m2 Anthracycline (doxorubicin): (N = 12 high risk/very high risk) mean ± SD: 349 ± 16 mg/m2 Cardioprotective treatment: Not reported |