Effect of selenium on anthracycline induced cardiotoxicity in children that treated for cancer: Correlation with pro-brain natriuretic peptide levels

Abstract

10061 Background: High cumulative doses of an anthracyclin (300–500 mg/m2) are used in the several treatment protocols of children with Cancer. Probrain natriuretic peptit (Pro-BNP), is relased by cardiac cells and elevated even before overt cardiac distress symptoms. Selenium, is an antioxidant which its’ absence cause cardiomyopathy in people living in the poor selenium soil area. Aim 1: Assesment of anthracycline-induced cardiotoxicity with Pro-BNP levels, correlated with echo-cardiographic (ECHO) findings. Aim 2: Determine possible effects of selenium levels and supplemantation on cardiac toxicity. Methods: Plasma levels of Pro-BNP have been measured in 58 pediatric cancer patients (leukemias, lymphomas,solid tumors; 38 boys, 20 girls; between 2–18 years, median:12) after completed their anthracycline containing regimens. Serum selenium levels examined in 12 patients (six patients were with high and other six with normal pro-BNP levels). Three of four Patients with low level of selenium showed cardiac failure according to ECHO and supplemanted with selenium besides digoxine, ACE inhibitors. Results: Eleven patients have found with high pro-BNP levels (120–8022 pg/ml; normal: lower than 120 pg/ml).Six of these patients (with 170–8022 pg/ml, median:798pg/ml pro-BNP) and other six patients with normal levels of pro-BNP (10–74pg/ml, median: 67pg/ml) examined for their serum selenium levels. All patients with normal pro-BNP levels have found in normal levels of selenium levels (71–150 μg/L,median:125 μg/L). Four patients in high pro-BNP group showed low levels of selenium (52–129 μg/L; median:67.5 μg/L). Since three of that four patients have cardiac failure, treated accordingly and supplemented with 100 μg/day selenium to maintain normal levels. During follow-up periods of 27; 8 and 2 months, all 3 patients are doing well with normal ECHO finding. Two patients reached normal Pro-BNP levels while one of them has 80 % decrease. Conclusions: Serum Pro-BNP levels can be used as a marker for anthracycline toxicity and as follow-up marker for protective agents. Selenium suplemantation may have a potential role to protect and/or overcome the difficulties related anthracyclin-induced toxicities. No significant financial relationships to disclose.