Cardiac Dysfunction Associated With Chemotherapy In A Pediatric Patient: Case Report

Authors

DOI:

https://doi.org/10.11606/issn.1679-9836.v103i5e-226320

Keywords:

Echocardiography, Chemotherapy, Cardiotoxicity, Non-Hodgkin's Lymphoma

Abstract

Introduction: Due to advances in antineoplastic treatments, there has been a notable improvement in the outlook of cancer patients. However, it is crucial to highlight that the cardiotoxicity associated with these therapeutic approaches is recognized as one of the most significant adverse effects. This phenomenon is characterized by the ability of chemical agents or therapeutic procedures to induce damage to the heart muscle, resulting in compromised cardiac function. Objectives: To present a case report of a patient suffering from Non-Hodgkin's Lymphoma (NHL), with impaired cardiac function due to cardiotoxicity. Methods: This is a descriptive observational study, of the case report type, which describes the clinical manifestations and management of a patient with cardiac dysfunction associated with chemotherapy. The research data used were collected through medical records made available by the public health service reference in pediatric oncology in the city of João Pessoa-PB. Results: Report the case of an 18-year-old pediatric patient, diagnosed with non-Hodgkin's Lymphoma, presenting with underlying heart disease, who underwent chemotherapy treatment, developing cardiotoxicity that led to death. Conclusion: Therefore, it is essential that continuous monitoring is implemented throughout the entire cancer treatment. Additionally, it is necessary to ensure that patients have broad access to diagnostic tests and chemotherapy with a cardioprotective profile, aiming to minimize the risk of cardiotoxicity. These measures are essential to reduce the incidence of adverse effects on the myocardium and improve the safety and effectiveness of oncological treatment.

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References

Silva J. Dia Internacional do Câncer na Infância. Ministério da Saúde do Brasil. 2022 Acesso em 22 de maio de 2024. https://bvsms.saude.gov.br/15-02-dia-internacional-do-cancer-na-infancia-2/#:~:text=O%20c%C3%A2ncer%20%C3%A9%20a%20principal,Am%C3%A9rica%20Latina%20e%20no%20Caribe.

OPAS pede maior acesso ao diagnóstico e tratamento para crianças e adolescentes com câncer na América Latina e no Caribe - OPAS/OMS | Organização Pan-Americana da Saúde. Acesso em 22 de maio de 2024 www.paho.org. https://www.paho.org/pt/noticias/16-9-2021-opas-pede-maior-acesso-ao-diagnostico-e-tratamento-para-criancas-e-adolescentes

Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA). A importância do diagnóstico precoce no câncer pediátrico. Rev Bras Cancerol. Acesso em 20 de setembro de 2023. https://rbc.inca.gov.br/index.php/revista/article/view/1747/1037

Pedrosa MF, Pedrosa F, Lins MM, Pontes Neto NT, Falbo GH. Linfoma não-Hodgkin na infância: características clínico-epidemiológicas e avaliação de sobrevida em um único centro no Nordeste do Brasil. J Pediatr. 2007;83(6):547-54. https://www.scielo.br/j/jped/a/LcS7zRBDmcGN8NPtx5yBLwC/?lang=pt Doi: https://doi.org/10.2223/JPED.1726

Hajjar LA, et al. Diretriz Brasileira de Cardio-Oncologia – 2020. Arq Bras Cardiol. 2020;115(5):1006-43. Doi: https://doi.org/10.36660/abc.20201006.

Minami M, Matsumoto S, Horiuchi H. Efeitos colaterais cardiovasculares da terapia moderna contra o câncer. Circ J. 2010;74. Disponível em: https://www.sciencedirect.com/science/article/pii/S0870255113000334#bib0015.

Spinelli A. Chemotherapeutic of cardiotoxicity [Internet]. Meneses E, editor. Ensaios USF. Ensaio USF; 2022 [cited 2024 Aug 1]. http://ensaios.usf.edu.br

Souza NNF, Roscani MG, Polegato BF, Pereira EJ, Ferreira AL, Matsubara LS et al. Avaliação ecocardiográfica da cardiotoxicidade aguda induzida por doxorrubicina em ratos. Rev Bras Ecocard Imagem Cardiovasc. 2009;22(3):20-5.

Schmidt LF, Pereira Junior M, Marinho APR, Moraes AJP, Rousseng SC, Rafael AD, et al. O exercício físico como potencial redutor da cardiotoxicidade induzida por tratamentos antineoplásicos: revisão sistemática. Rev Bras Prescrição Fisiol Exerc. (RBPFEX). 2017;11(69):692-702

Calle E, Kaaks R. Excesso de peso, obesidade e câncer: evidências epidemiológicas e mecanismos propostos. Nat Rev Câncer. 2004;4:579-91. https : //www.ncbi.n.NIH.gov /pm/arte/PMC/#bibr11-153.

Instituto Nacional de Câncer José Alencar Gomes da Silva. Estimativa 2023: incidência de câncer no Brasil. Rio de Janeiro: INCA; 2023. https://www.inca.gov.br /sites /u.sti .inc.local /f/mídia /documento/estimativa--2023 .pdf .

Calle EE, Kaaks R. Overweight, Obesity and Cancer: Epidemiological Evidence and Proposed Mechanisms. Nat Rev Cancer. 2004 Aug;4(8):579-591. https://doi.org/10.1038/nrc1408.

Santos MO, Lima FCS, Martins LFL, Oliveira JFP, Almeida LM, Cancela MC. Estimativa de Incidência de Câncer no Brasil, 2023-2025. Rev Bras Cancerol. 2023;69(1):e213700. https://doi.org/10.32635/2176-9745.rbc.2023v69n1.3700.

Klumb CE. Biologia e Patogênese dos Linfomas não Hodgkin de Origem B na Infância: uma Revisão. Rev Bras Cancerol. 2001;28;47(3):291-301.

Brasil. Linfoma Não Hodgkin. Instituto Nacional de Câncer - INCA; 22 de junho de 2022. http://www.gov.br/inca/pt-br/assuntos/cancer/tipos/linfoma-nao-hodgkin.

Fisher RI. Autologous Stem-Cell Transplantation as a Component of Initial Treatment for Poor-Risk Patients with Aggressive Non-Hodgkin’s Lymphoma: Resolved Issues versus Remaining Opportunity. J Clin Oncol. 2002;20(22):4411–12. Doi: https://doi.org/10.1200/JCO.2002.20.22.4411.

Adão R, de Keulenaer G, Leite-Moreira A, Brás-Silva C. Cardiotoxicidade associada à terapêutica oncológica: mecanismos fisiopatológicos e estratégias de prevenção. Rev Port Cardiol. 2013;32(5):395-409. https://www.revportcardiol.org/pt-cardiotoxicidade-associada-a-terapeutica-oncologica-articulo-S0870255113000334

Biblioteca Digital de Trabalhos Acadêmicos da Universidade de São Paulo. https://bdta.abcd.usp.br/directbitstream/3e73b088-16d1-40ea-bc17-08da479c6469/CAROLINA%20BUZZULINI%20-%20Biomarcadores%20card%C3%ADacos%20na%20detec%C3%A7%C3%A3o%20precoce%20de%20cardiotoxicidade%20induzida%20pela%20terapia%20antic%C3%A2ncer%20revis%C3%A3o.pdf.

Tan C, Tasaka H, Yu KP, Murphy ML, Karnofsky DA. Daunomycin, an antitumor antibiotic, in the treatment of neoplastic disease. Clinical evaluation with special reference to childhood leukemia. Cancer. 1967;20(3):333-53. Doi: 10.1002/1097-0142(1967)20:3<333::aid-cncr2820200302>3.0.co;2-k. PMID: 4290058.

Lyon AR, López-Fernández T, Couch LS, Asteggiano R, Aznar MC, Bergler-Klein J, et al. 2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS). Eur Heart J. 2022;26;43(41): 4229-361. Doi: 10.1093/eurheartj/ehac244

Narezkina A, Nasim K. Anthracycline Cardiotoxicity. Circ Heart Fail. 2019;12(3):e005910. Doi: 10.1161/CIRCHEARTFAILURE.119.005910. PMID: 30871350.

Published

2024-10-30

Issue

Section

Relato de Caso/Case Report

How to Cite

Adriano, M. P. F. ., Fernandes, L. A. ., Arruda , I. T. S. de, Quintans, Y. N. de L. S. ., & Martins, J. L. . (2024). Cardiac Dysfunction Associated With Chemotherapy In A Pediatric Patient: Case Report. Revista De Medicina, 103(5), e-226320. https://doi.org/10.11606/issn.1679-9836.v103i5e-226320