THE UTILITY OF SERIAL EVALUATION OF cTnI AND BNP IN EARLY DETECTION OF ANTHRACYCLINE-INDUCED CARDIOTOXICITY IN CHILDREN

Aim. Early detection of chemotherapy cardiotoxicity in pediatric patients by using sensitive and specific methods. Material and methods: The study group included 34 patients with malignancies, aged between 3-18 years. We evaluate the patients through history, physical examination, electrocardiogram, 2D/ Doppler echocardiography, cardiac biomarkers - BNP (B-type natriuretic peptide) and cTnI (cardiac troponin I), at baseline and subsequently, in dynamic. Results: Cardiotoxicity was revealed in 24 patients (70.5%), with clinical manifestations in 2 cases (5.8%). Echocardiographic changes were found in 26 cases (76.4%) (16 cases-47% with systolic dysfunction, 26 cases-76.4% with diastolic dysfunction), electrocardiographically changes in 73.5% of cases. Elevated plasma BNP was found in 18 patients-52.9%, and cTnI levels were normal in all patients (cut-off 0.04ng/mL).  Elevated levels of BNP have been correlated with the cumulative dose of anthracyclines and therapeutic protocol received. Conclusions: The study may give solutions for the reduction and prevention of cardiotoxicity, even when are used higher doses of anthracyclines with a higher rate of healing while improving the quality of life of survivors.