Ongoing research in the field of pediatric oncology has led to an increased number of childhood cancer survivors reaching adulthood. Therefore, ensuring a good quality of life for these patients has become a rising priority. Considering this, the following review focuses on summarizing the most recent research in anthracycline-induced cardiac toxicity in children treated for leukemia. For pediatric cancers, anthracyclines are one of the most used anticancer drugs, with over half of the childhood cancer survivors believed to have been exposed to them. Anthracyclines cause irreversible cardiomyocyte loss, leading to chronic, progressive heart failure. The risk of developing cardiotoxicity has been known to increase with the treatment-free interval and total cumulative dose. However, because of individual variations in anthracycline metabolism, it has recently been shown that there is no risk-free dose. Moreover, studies have shown that diagnosing anthracycline-induced cardiomyopathy in the symptomatic phase is associated with poor treatment response and prognosis. Thus, early and systematic evaluation of these patients is crucial to allow optimal therapeutic intervention. Although currently echocardiographic assessment of left ventricle ejection fraction and cardiac biomarker evaluation are being used for cardiac function monitoring in oncologic patients, there is no established follow-up and treatment protocol for these patients, and these methods are neither specific nor sensitive for identifying early cardiac dysfunction. All things considered, the need for ongoing research in the field of pediatric cardiooncology is crucial to offer these patients a chance at a good quality of life as adults.

中文翻译：

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心脏毒性：儿童白血病治疗的重大挫折

儿科肿瘤学领域的持续研究导致越来越多的儿童癌症幸存者进入成年期。因此，确保这些患者的良好生活质量已成为日益重要的优先事项。考虑到这一点，以下综述重点总结了蒽环类药物引起的白血病儿童心脏毒性的最新研究。对于儿科癌症，蒽环类药物是最常用的抗癌药物之一，据信超过一半的儿童癌症幸存者曾接触过蒽环类药物。蒽环类药物会导致不可逆的心肌细胞丢失，从而导致慢性进行性心力衰竭。已知发生心脏毒性的风险随着无治疗间隔和总累积剂量的增加而增加。然而，由于蒽环类药物代谢的个体差异，最近表明没有无风险的剂量。此外，研究表明，在症状阶段诊断蒽环类药物诱发的心肌病与较差的治疗反应和预后有关。因此，对这些患者进行早期和系统评估对于实现最佳治疗干预至关重要。虽然目前左心室射血分数的超声心动图评估和心脏生物标志物评估被用于肿瘤患者的心脏功能监测，但没有针对这些患者的既定随访和治疗方案，这些方法对于识别早期心脏疾病既不特异也不敏感功能障碍。所有的情况都被考虑到了，