Selenium in the prevention of anthracycline-induced cardiac toxicity in children with cancer

High cumulative doses of anthracyclines (300500 mg/m2) used in the treatment of children with cancer may result in cardiotoxicity,a major long-term adverse effect that limits clinical usefulness of this class of chemotherapeutic agents. we assessed anthracycline-induced cardiotoxicity by measuring pro-bnp levels and echocardiographic (echo) findings and investigated potential protective effect of selenium (se) supplementation in a group of pediatric cancer patients. plasma level of pro-bnp was measured,and echo was performed in 67 patients (45 boys,22 girls; ages 218 years; median age 12 years) after they completed anthracycline-containing chemotherapy. serum se level was measured in 37 patients. eleven patients had high pro-bnp levels and/or cardiac failure with pro-bnp levels of 108,022 pg/ml (median 226.3 pg/ml; laboratory normal level is less than 120 pg/ml). serum se levels were low (20129 mcg/l,median 62 mcg/l) in ten of these eleven patients. eight of 10 patients with low se and high pro-bnp levels were supplemented with se 100 mcg/day for a period of 433 months (median 6 months) which resulted in improvement in pro-bnp and/or echo findings. these results suggest that se supplementation may have a role in protection against anthracycline-induced cardiac toxicity. © 2012 nurdan tacyildiz et al.