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. 2019 Mar;19(1):1647-1656.
doi: 10.4314/ahs.v19i1.40.

Anthracycline induced cardiotoxicity in adult cancer patients: a prospective cohort study from a specialized oncology treatment centre in Uganda

Solomon Kibudde  1 , Charles Kiiza Mondo  2 , Davis Kibirige  3 , Victoria Walusansa  1 , Jackson Orem  1
Affiliations

Anthracycline induced cardiotoxicity in adult cancer patients: a prospective cohort study from a specialized oncology treatment centre in Uganda

Solomon Kibudde et al. Afr Health Sci. 2019 Mar.

Abstract

Purpose: To determine the cumulative incidence of anthracycline induced cardiotoxicity (AIC), its predictors, and associated electrocardiographic and echocardiographic manifestations in adult cancer patients at Uganda Cancer Institute (UCI).

Methods: We enrolled 160 participants between June 2013 and April 2014 and followed them up for a median of 146 days. Data on clinical, electrocardiographic and echocardiographic findings was obtained at baseline, and at completion of chemotherapy. The Pearson chi square test was used to identify the predictors associated with cardiotoxicity.

Results: Of the 64 patients who were accessible for follow-up electrocardiography (ECG) and echocardiography (ECHO), fourteen participants developed cardiotoxicity hence a cumulative incidence rate of 21.9% with 95% CI 13.5%-33.43%. The predictors of AIC were female gender (p=0.025), LVEF (p=0.014) and LVFS (P=0.019). Anthracycline therapy was associated with shortening of the QRS duration (84.3±7.9 Vs 82.1±11.8 ms, p=0.005), prolongation of the QTc interval (411.9±30.7 Vs 447.2±39.4 ms, p=<0.001) and reduction in the LVEF (66.4±7.7 Vs 63.9±8.4%, p=0.026) and LVFS (36.9±6.2 Vs 35.1±6.6%, p=0.03).

Conclusion: The cumulative incidence of AIC in this study cohort was high. Our findings emphasize the need for early monitoring for AIC.

Keywords: Anthracycline induced cardiotoxicity; Uganda; cancer patients.

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Figures

Figure 1
Figure 1
Study flow diagram showing the cohort at different stages Note: NHL — Non-Hodgkin's Lymphoma, HD — Hodgkin's Disease, AML — Acute Myeloid Leukemia, ALL — Acute Lymphoblastic Leukemia, HCC — Hepatocellular Carcinoma, ECG — Electrocardiogram, ECHO — Echocardiogram, ECOG — Eastern Cooperative Oncology Group
Figure 2
Figure 2
showing the change in ejection fraction by the different age groups.
Figure 3
Figure 3
Box plot showing change in left ventricle ejection fraction according to the different cancers.
See this image and copyright information in PMC

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