# Anthracycline-Induced Cardiomyopathy: Prevalence and Risk Factors Among Pediatric Cancer Patients in a Tertiary Care Center in Jeddah, Saudi Arabia

## TL;DR

This study examines how often anthracycline chemotherapy causes heart problems in children with cancer in Saudi Arabia and identifies risk factors.

## Contribution

The study provides new prevalence data and risk factors for anthracycline-induced cardiomyopathy in Saudi pediatric cancer patients.

## Key findings

- 7.34% of pediatric patients developed cardiomyopathy after anthracycline treatment.
- Thromboembolism, PDA, and cancer type were significantly associated with cardiomyopathy.
- Traditional factors like age, gender, and cumulative dose were not predictive.

## Abstract

Chemotherapy-induced cardiomyopathy (CCMP) is one of the well-defined toxicities associated with chemotherapy use that can lead to serious side effects. An example of a chemotherapeutic drug class that has been well documented over the years to cause CCMP is anthracyclines. To date, few studies have been carried out in Saudi Arabia on the prevalence of CCMP and the associated risk factors. Therefore, the objective of our research is to measure the prevalence and determine the risk factors of such phenomena. This is a comparative cross-sectional study. Data from 114 patients was retrieved from the medical records of the cardiac department at Princess Noorah Oncology Center, King Abdulaziz Medical City. The research included pediatric oncology patients aged 14 or under who were treated with anthracyclines from June 2016 to May 2024. We excluded patients who did not undergo ECHO. A consecutive sampling technique was used to collect the patients. Over the eight-year study period, we found that 7.34% (8/109) of the cohort developed CCMP, with a mean age at diagnosis of 6.39 ± 3.81 years. The mean dose of anthracycline received until the diagnosis of CCMP was 194.77±145.92 mg, with a median interval between anthracycline initiation and CCMP diagnosis of 13.65 (3-89) weeks. A significant association was found between thromboembolism, PDA, type of cancer, and the development of CCMP. We found that traditional predictors such as gender, age at diagnosis, and cumulative anthracycline dose were not predictors of CCMP.