Abstract 5949: Abnormal NT-Pro-BNP Levels in Asymptomatic Long Term Survivors of Childhood Cancer Treated with Anthracyclines

Abstract

Objectives : to document plasma concentrations of cardiac Troponin T (cTnT) and NT-pro-brain natriuretic peptide (NT-pro-BNP) in a large group of asymptomatic long term survivors of childhood cancer treated with anthracyclines, to study the relation of the abnormal biomarker levels with different risk factors for anthracycline-induced cardiotoxicity and conventional echocardiographic parameters. Methods : 122 asymptomatic survivors of childhood cancer underwent a detailed echocardiography. Blood samples were taken to determine the levels of NT-pro-BNP and cTnT. Results : None of the survivors had abnormal cTnT levels. The mean NT-pro-BNP level of our survivor group was 10 pmol/l (SD±9) with a range of 1–55 pmol/l. Thirteen percent of the survivors had abnormal NT-pro-BNP levels. Abnormal NT-pro-BNP levels were significantly related to cumulative anthracycline dosage (p<0.003). Eleven of 31 (35%) survivors treated with cumulative anthracycline dose of 300 mg/m 2 or more, had abnormal NT-pro-BNP levels which were significantly related to end-diastolic left ventricular internal diameter (LVIDd) indexed for body surface area (BSA) (p<0.01). Conclusion : Cardiac TnT does not contribute to the early detection of late onset anthracyline-induced cardiotoxicity. Abnormal levels of NT-pro-BNP were frequently detected in asymptomatic, long term survivors of childhood cancer. Follow up of these survivors, with both echocardiography and NT-pro-BNP, is essential to answer the question whether NT-pro-BNP is an early marker for late onset anthracycline-induced cardiotoxicity.