Table 4.
Cardiac biomarker levels before and after therapy in children with cancer treated with anthracyclines, mitoxantrone and/or radiotherapy involving the heart
| Study | Number of participants | Biomarker level before therapya | Timing of measurement after therapyb | Biomarker level after therapya | P value |
|---|---|---|---|---|---|
| Troponin | |||||
| Troponin I (ng/mL) | |||||
| Al-Biltagi 2012 [28] | 25 | 0.055 ± 0.003 | Acute | 0.061 ± 0.005 | 0.002 |
| El Amrousy 2022 [62] | 30 | Mean < 0.01 | Acute/early | 0.050 ± 0.012 | < 0.05 |
| El-Shitany 2012 [37] | 25 | nm | Acute/early | 0.061 ± 0.005 | nm |
| Troponin I (pg/mL) | |||||
| Hagag 2019 [42] | 40 | 37.3 ± 8.71 | Acute/early | 75.5 ± 7.71 | 0.027 |
| Radu 2019 [53] | 48 | Median 0.1, IQR 0.1–0.1 | Acute | Median 0.1, IQR 0.1–0.1 | nm |
| Early | Median 0.1, IQR 0.1–0.2 | < 0.001 | |||
| Cardiac troponin I (ng/mL) | |||||
| Erkus 2007 [38] | 29 | 0.020 ± 0.006 | Early | 0.024 ± 0.009 | nm |
| Gupta 2018 [41] | 40 | 0.01 ± 0.00 | Early | 0.011 ± 0.003 | nm |
| Oztarhan 2011 [52] | 276 | 0.02 ± 0.22 | Acute/early | Cumulative ANT dose 30-90 mg/m2: 0.02 ± 0.01 | nm |
| Cumulative ANT dose 120-180 mg/m2: 0.02 ± 0.02 | nm | ||||
| Cumulative ANT dose ≥ 210 mg/m2: 0.04 ± 0.14 | nm | ||||
| Cardiac troponin C (ng/mL) | |||||
| Hu 2018 (2) [44] | 131 | nm | Acute | Cumulative PIR dose < 100 mg/m2: mean < 0.05 | nm |
| Cumulative PIR dose 100-200 mg/m2: mean < 0.05 | nm | ||||
| Cumulative PIR dose ≥ 200 mg/m2: mean < 0.05 | nm | ||||
| Mavinkurve-Groothuis 2013 [49] | 60 | Median 0.01 | Early | 0.01, 0.01–0.02 | nm |
| High-sensitive cardiac troponin T (ng/L) | |||||
| Cheung 2020 | 39 | 3.50 ± 5.44 | Early | 11.53 ± 8.52 | < 0.001 |
| Brain natriuretic peptide (pg/mL) | |||||
| Erkus 2007 [38] | 29 | 4.09 ± 2.26 | Early | 7.47 ± 3.16 | < 0.05 |
| N-terminal prohormone of brain natriuretic peptide (pg/mL) | |||||
| El Amrousy 2022 [62] | 30 | 37.1 ± 7.7 | Acute/early | 88.8 ± 13.6 | < 0.05 |
| Gupta 2018 [41] | 40 | 5.00 ± 0.00 | Early | 98.60 ± 54.24 | nm |
| Hu 2018 (2) [44] | 131 | nm | Acute | Cumulative PIR dose < 100 mg/m2: 142.93 ± 104.43 | - |
| Cumulative PIR dose 100-200 mg/m2: 158.27 ± 78.18 | 0.978 ‡ | ||||
| Cumulative PIR dose ≥ 200 mg/m2: 1725.90 ± 5634.78 | 0.013 ‡ | ||||
| N-terminal prohormone of brain natriuretic peptide (pmol/L) | |||||
| Mavinkurve-Groothuis 2013 [49] | 60 | 13, 2–185 | Early | 11, 1–68 | nm |
| Creatine kinase (U/L) | |||||
| Al-Biltagi 2012 [28] | 25 | 50.60 ± 8.55 | Acute | 48.61 ± 6.56 | 0.62 |
| El-Shitany 2012 [37] | 25 | 50.6 ± 25.67 | Acute/early | 47.6 ± 20.45 | nm |
| Creatine kinase, myocardial band (U/L) | |||||
| El Amrousy 2022 [62] | 30 | 11.6 ± 3.6 | Acute/early | 46 ± 7.2 | < 0.05 |
| Hu 2018 (2) [44] | 131 | nm | Acute | Cumulative PIR dose < 100 mg/m2: 30.06 ± 11.43 | - |
| Cumulative PIR dose 100-200 mg/m2: 27.53 ± 8.80 | nm | ||||
| Cumulative PIR dose ≥ 200 mg/m2: 25.67 ± 12.31 | nm | ||||
| Creatine kinase, myocardial band (ng/mL) | |||||
| Gupta 2018 [41] | 40 | 1.00 ± 0.00 | Early | 1.21 ± 0.44 | nm |
Abbreviations: ANT Anthracycline, IQR Interquartile range, PIR Pirarubicin
aunless otherwise specified, mean is provided with standard deviation (x ± y) and median with range (x, y–z)
bacute (within one week after a treatment); early (within one year after start of treatment); acute/early (acute and early not separable)
‡ P values in comparison to the lowest dose group are presented