Prospective longitudinal examinations of anthracycline‐induced cardiomyopathy in a homogeneous cohort are rare in pediatric oncology. We herein report the results of observations on the frequency of cardiomyopathy in doxorubicin‐treated sarcoma patients in Germany, Austria, and Switzerland.

The Late Effects Surveillance System (LESS) prospectively collects longitudinal data on late sequelae of antineoplastic therapy in Ewing‐, soft tissue‐, and osteosarcoma patients treated within the therapy trial protocols of the German Society of Pediatric Oncology and Hematology. Two hundred sixty‐five relapse‐free patients who had received doxorubicin for the treatment within the EICESS‐92/EURO‐E.W.I.N.G.‐99, COSS‐96, and CWS‐96 therapy trials were serially examined by echocardiography. The analyzed population consisted of 142 males and 123 females. Their mean age at the end of therapy was 13 ± 5 years. The mean follow‐up time was 34 ± 12 months. The mean cumulative doxorubicin dose was 290 ± 91 mg/m².

In this cohort, the total cumulative incidence of doxorubicin‐induced cardiomyopathy was 7.5%. Four patients (1.5%) suffered from a symptomatic cardiomyopathy and 16 (6%) from a subclinical cardiomyopathy. Cardiomyopathy manifested in 11 cases already under antineoplastic therapy and in the remaining nine cases at a median of 26 days (range: 17–174 days) after stopping antineoplastic therapy. Univariate and multivariable analysis did not confirm any of the known risk factors for developing anthracycline‐induced cardiomyopathy in our patient group within the described time interval.

After a mean follow‐up of 34 ± 12 months, cumulative incidence of doxorubicin‐induced cardiomyopathy in our pediatric sarcoma patients was at the lower end of that reported by other groups. Pediatr Blood Cancer 2006, 46:489–495. © 2005 Wiley‐Liss, Inc.