Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2012
Changes in cardiac biomarkers during doxorubicin treatment of pediatric patients with high-risk acute lymphoblastic leukemia: associations with long-term echocardiographic outcomes.
Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 146 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
146 citing papers in PubMed, 3 syntheses or guidelines pooled it, 321 citations in OpenAlex.
- Dexrazoxane for preventing or reducing cardiotoxicity in adults and children with cancer receiving anthracyclines.The Cochrane database of systematic reviews · 2022Pooled it
- Cardiac biomarkers for the detection of cardiotoxicity in childhood cancer-a meta-analysis.ESC heart failure · 2020Pooled it
- Recommendations for cardiomyopathy surveillance for survivors of childhood cancer: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group.The Lancet. Oncology · 2015Guideline
- Genetic Polymorphisms Affecting Cardiac Biomarker Concentrations in Children with Cancer: an Analysis from the "European Paediatric Oncology Off-patents Medicines Consortium" (EPOC) Trial.European journal of drug metabolism and pharmacokinetics · 2020Trial
- Long-term systolic function in children and young adults after hematopoietic stem cell transplant.Bone marrow transplantation · 2017Trial
- Pharmacokinetic and pharmacodynamic study of doxorubicin in children with cancer: results of a "European Pediatric Oncology Off-patents Medicines Consortium" trial.Cancer chemotherapy and pharmacology · 2016Trial
- Trial
- Cardioprotection and Safety of Dexrazoxane in Patients Treated for Newly Diagnosed T-Cell Acute Lymphoblastic Leukemia or Advanced-Stage Lymphoblastic Non-Hodgkin Lymphoma: A Report of the Children's Oncology Group Randomized Trial Pediatric Oncology Group 9404.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2016Trial
- Continuous Versus Bolus Infusion of Doxorubicin in Children With ALL: Long-term Cardiac Outcomes.Pediatrics · 2012Trial
- Review
- Exploratory Evaluation of Cardiac Fatty Acid-Binding Protein (H-FABP), Troponin I, NT-proBNP, Echocardiography, and Holter Monitoring for the Assessment of Doxorubicin-Induced Cardiac Damage in Dogs.Veterinary sciences · 2026Article
- Cardiotoxicity induced by traditional chemotherapy: mechanisms and mitigation strategies.Apoptosis : an international journal on programmed cell death · 2026Review
- Toward Precision in Myocardial Injury Management: A Critical Synthesis and the C.A.L.I.B.R.A.T.E. Framework for Biomarker Integration.Clinical Medicine Insights. Cardiology · 2026Review
- Is creatine kinase a valid aid in early cardiac muscle damage detection during treatment for childhood acute lymphoblastic leukemia? A case report.Frontiers in oncology · 2026Article
- Emerging Strategies for the Prevention of Chemotherapy-Induced Cardiotoxicity in Paediatric Cancer Patients: Advances and Future Perspectives.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Cardiovascular Toxicity in Patients Treated for Childhood Cancer: A Scientific Statement From the American Heart Association.Circulation · 2025Review
- Article
- Cardioprotective strategies in the management of chemotherapy-induced cardiotoxicity: current approaches and future directions.Annals of medicine and surgery (2012) · 2024Review
- Troponin Elevation in Asymptomatic Cancer Patients: Unveiling Connections and Clinical Implications.Current heart failure reports · 2024Review
- Pediatric Cardio-Oncology: Screening, Risk Stratification, and Prevention of Cardiotoxicity Associated with Anthracyclines.Children (Basel, Switzerland) · 2024Review
86 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 1 institution in 1 country.
Funding
Abstract
purposeDoxorubicin causes cardiac injury and cardiomyopathy in children with acute lymphoblastic leukemia (ALL). Measuring biomarkers during therapy might help individualize treatment by immediately identifying cardiac injury and cardiomyopathy. PATIENTS AND
methodsChildren with high-risk ALL were randomly assigned to receive doxorubicin alone (n = 100; 75 analyzed) or doxorubicin with dexrazoxane (n = 105; 81 analyzed). Echocardiograms and serial serum measurements of cardiac troponin T (cTnT; cardiac injury biomarker), N-terminal pro-brain natriuretic peptide (NT-proBNP; cardiomyopathy biomarker), and high-sensitivity C-reactive protein (hsCRP; inflammatory biomarker) were obtained before, during, and after treatment.
resultscTnT levels were increased in 12% of children in the doxorubicin group and in 13% of the doxorubicin-dexrazoxane group before treatment but in 47% and 13%, respectively, after treatment (P = .005). NT-proBNP levels were increased in 89% of children in the doxorubicin group and in 92% of children in the doxorubicin-dexrazoxane group before treatment but in only 48% and 20%, respectively, after treatment (P = .07). The percentage of children with increased hsCRP levels did not differ between groups at any time. In the first 90 days of treatment, detectable increases in cTnT were associated with abnormally reduced left ventricular (LV) mass and LV end-diastolic posterior wall thickness 4 years later (P < .01); increases in NT-proBNP were related to an abnormal LV thickness-to-dimension ratio, suggesting LV remodeling, 4 years later (P = .01). Increases in hsCRP were not associated with any echocardiographic variables.
conclusioncTnT and NT-proBNP may hold promise as biomarkers of cardiotoxicity in children with high-risk ALL. Definitive validation studies are required to fully establish their range of clinical utility.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.