Table 1 Australian and New Zealand Pediatric Cardio-Oncology recommended indications for referral to a pediatric cardio-oncology clinic
From: Lessons learnt in the first year of an Australian pediatric cardio oncology clinic
Domain | Consensus definitions / Approach |
|---|---|
Domain 1 | Defining high-risk pediatric oncology patients that should be reviewed by experts in cardio-oncology during acute therapy. An individual will be considered high-risk if: ▪ they have received a total cumulative dose ≥250 mg/m2 (doxorubicin equivalent). ▪ the individual has relapsed and the cumulative doxorubicin equivalent dose (as part of first- or second-line therapy) will be ≥250 mg/m2. ▪ they have received any dose of anthracycline combined with radiotherapy ≥15Gy and where any area of the heart is involved in the treatment field as part of first- or second-line therapy. ▪ they have received radiotherapy ≥35Gy and where any area of the heart is involved in the treatment field as part of first- or second-line therapy. ▪ they have pre-existing congenital heart disease, a relevant family history of cardiovascular disease (including genetic disorders that impact heart structure and storage disorders but excluding adult-type cardiac disease i.e., myocardial ischemia, coronary artery disease etc) and those with previous abnormal left ventricular dysfunction. ▪ they are receiving treatment with VEGF inhibitors, mTOR inhibitors, proteasomal inhibitors, checkpoint inhibitors. They should ideally be seen at least once within a cardio-oncology clinic (if facilities exist), or more frequently to manage any potential associated cardiotoxicities as evidence emerges. ▪ in circumstances where the clinician screens for metabolic syndrome in pediatric cancer individuals and are diagnosed with metabolic syndrome. ▪ they have chronic kidney disease. ▪ they are an adolescent or young adult individual who is pregnant whilst receiving cancer therapy. |