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Late Effects





10 – 15% of all cardiomyopathies in young adults are related to previous treatment for cancer.

Cardiac injury is a significant cause of mortality and morbidity in cancer survivors (10X risk compared to general population)6

Cardiopulmonary disease is the 3rd most common cause of death for patients after treatment for a pediatric malignancy.

For long-term survivors of childhood cancer:

  • First cause of death: Recurrence of the primary malignancy
  • Second cause of death: Second malignancy6
  • Third cause of death: Cardiac Injury


The risk of Injury to the heart depends on:

Patient factors:

  • Genetic factors
    • pharmacogenomics
    • Down's syndrome ( trisomy 21)
    • gender4

Tumor factors:

  • Direct extension of the tumor to involve the heart

Treatment factors:

  • Radiation Therapy4
  • Chemotherapy
    • Anthracyclines are most commonly associated with cardiac damage (daunorubicin and doxorubicin)4

Damage to the heart may present as:

  • Cardiomyopathy (heart muscle damage - dilated and/or restrictive)
  • Premature ischemic heart disease
  • Pericarditis
  • Valvular injury


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