Early myocardial injury in children on doxorubicin for cancer chemotherapy - a cross-sectional study in a tertiary referral centre in Kenya

Q: Which factors were associated with elevated cTnT?

A cumulative doxorubicin dose > 175 mg/m2 was significantly associated with elevated cTnT, and nephroblastoma was also associated though not statistically significant.

Sep 22, 2026

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Use of doxorubicin in childhood cancer chemotherapy is linked to late cardiac toxicities, making early cardiac effect detection essential to prevent myocardial dysfunction and other adverse outcomes. A cross-sectional, hospital-based study in Kenya investigated the prevalence of elevated serum cardiac troponin T (cTnT) and related factors of myocardial injury, with echocardiography and cTnT assessment before and 24 hours after infusion. Findings included elevated cTnT and myocardial injury measures, and associations with cumulative dose and diagnosis.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Introduction

Background on doxorubicin and cardiac toxicity

Methods

Study design and setting

Interventions and outcome definitions

Results

Prevalence of elevated cTnT and myocardial injury

Associated factors

Kariuki etal. BMC Cardiovascular Disorders (2024) 24:260 BMC Cardiovascular Disorders [https://doi.org/10.1186/s12872-024-03922-y](https://doi.org/10.1186/s12872-024-03922-y) RESEARCH Open Access Early myocardial injury in children on doxorubicin for cancer chemotherapy: a cross-sectional study in a tertiary referral centre in Kenya Nyambura Kariuki 1*† , Esther Kimani1† , Christine Jowi1, Dalton Wamalwa1, Jacky Y. Suen4,5 , John F. Fraser4,5 and Nchafatso G. Obonyo2,3,4,5* Abstract Introduction Use of doxorubicin, an anthracycline chemotherapeutic agent has been associated with late-occurring cardiac toxicities. Detection of early-occurring cardiac effects of cancer chemotherapy is essential to prevent occurrence of adverse events including toxicity, myocardial dysfunction, and death. Objective To investigate the prevalence of elevated cardiac troponinT (cTnT) and associated factors of myocardial injury in children on doxorubicin cancer chemotherapy. Methods Design: A cross-sectional study. Setting and subjects: A hospital-based study conducted on children aged 1-month to 12.4-years who had a diagnosis of cancer and were admitted at Kenyatta National Hospital (KNH) . Interventions and outcomes: The patients underwent Echocardiography (ECHO) before their scheduled chemotherapy infusion. Twenty-four (24) hours after the chemotherapy infusion the patients had an evaluation of the serum cardiac troponinT (cTnT) and a repeat ECHO. Myocardial injury was defined as cTnT level > 0.014 ng/ml or a Fractional Shortening (FS) of < 29% on ECHO. Results One hundred (100) children were included in the final analysis. Thirty-two percent (32%) of the study population had an elevated cTnT. A cumulative doxorubicin dose of > 175 mg/m2 was significantly associated with and elevated cTnT (OR, 10. 76; 95% CI, 1.18–97. 92; p = 0 . 035) . Diagnosis of nephroblastoma was also associated with an elevated cTnT (OR, 3 . 0; 95% CI, 1.23–7. 26) but not statistically significant (p = 0 . 105) . Nine percent (9%) of the participants had echocardiographic evidence of myocardial injury. †Nyambura Kariuki and Esther Kimani equal contribution to the realisation of this manuscript. *Correspondence: Nyambura Kariuki [dr. nyambura.kariuki@gmail.com](dr. nyambura.kariuki@gmail.com)[ ](dr. nyambura.kariuki@gmail.com)Nchafatso G. Obonyo[g.obonyo@uq.edu.au](g.obonyo@uq.edu.au) Full list of author information is available at the end of the article © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ()[. The Creative Commons Public Domain Dedication waiver (](http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ()[http://creativecom](http://creativecom)[mons.org/publicdomain/zero/1.0/](mons.org/publicdomain/zero/1.0/)) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Kariuki etal. BMC Cardiovascular Disorders (2024) 24:260 Page 2 of 9 Conclusion When compared to echocardiography, elevated levels of cTnT showed a higher associatio

FAQs

What is the study objective regarding doxorubicin and childhood cancer?

To investigate the prevalence of elevated cardiac troponin T (cTnT) and associated factors of myocardial injury in children receiving doxorubicin chemotherapy.

How was myocardial injury defined in the study?

Myocardial injury was defined as cTnT level > 0.014 ng/ml or a Fractional Shortening (FS) of < 29% on echocardiography.

Which factors were associated with elevated cTnT?

A cumulative doxorubicin dose > 175 mg/m2 was significantly associated with elevated cTnT, and nephroblastoma was also associated though not statistically significant.

Sep 22, 2026

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