Heart failure in pediatric oncologic disease

There have been tremendous advancements in treatments for various pediatric malignancies over the last 5 decades. However, cancer remains one of the leading causes of morbidity and mortality in children (Seigel et al., 2021; Lipshultz and Sallan, 1993). In 2022, approximately 10,470 children (birth to 14 years) and 5480 adolescents (aged 15-19 years) were diagnosed with cancer (Seigel et al., 2022). In addition, the number of survivors is increasing every day. As of January 1, 2022, the estimated number of US cancer survivors (birth to 14 years) was 69,920 (Miller et al., 2022). As oncologic treatments continue to improve the lifespan for cancer survivors, the short- and long-term side effects of chemotherapeutic regimens on organ systems are becoming increasingly important to understand (Lipshultz et al., 2013). These childhood survivors are at high risk of developing chronic health conditions and organ damage, which impair their quality of life. The effects on the heart and the cardiovascular system are perhaps most important, as they are the leading causes of morbidity and mortality in cancer survivors (Mertens et al., 2008). This chapter aims to highlight the mechanism and risk factors for cardiotoxicity, prevention of anthracycline cardiotoxicity, and various modalities for monitoring and managing cardiotoxicity. The goal of childhood cancer treatment is not only to cure the patient but also to try to ensure that the patient lives as long and as normal a life as possible (Lipshultz et al., 2010).