Serum troponin T levels and echocardiographic evaluation in children treated with doxorubicin

Pediatr Blood Cancer. 2004 Mar;42(3):220-4. doi: 10.1002/pbc.10368.


Objective: We investigated the usefulness of serum cardiac Troponin T (cTnT) to detect doxorubicin related cardiotoxicity as a non-invasive and reliable method.

Patients and methods: Twenty-four patients who received doxorubicin for their solid tumors at cumulative doses of 400 mg/m(2) or higher, between June 1982 and August 2000, were included in this study. None of them had clinical signs or symptoms of cardiotoxicity. The age range was 3-31 years (median 14), and male to female ratio was 14/10. The systolic and diastolic cardiac functions were evaluated by two-dimensional, M-mode, and Doppler echocardiography. Serum cTnT levels were measured by a third generation immunoassay method and the lowest detectable level was 0.010 ng/ml.

Results: The cumulative doxorubicin doses were at the range of 400 and 840 mg/m(2) (median 480). The time past from the last doxorubicin dose was 1-168 months (median 12). All of the patients had normal chest X-rays, electrocardiograms, and nine patients (37.5%) had abnormal systolic or diastolic cardiac function parameters. The median cumulative doxorubicin doses of the patients with normal and abnormal echocardiographic parameters were 480 and 440 mg/m(2), respectively. Serum cTnT values of 21 patients were below the detection limit (< 0.010 ng/ml). There was no statistical difference between serum cTnT levels of the patients with normal and abnormal echocardiographic findings (P = 0.376).

Conclusions: No correlation was found between serum cTnT values, cumulative doxorubicin doses, and systolic or diastolic cardiac functions. We can conclude that echocardiographic follow-up is more reliable than serum cTnT levels for detecting subclinical cardiac toxicity.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Agents / toxicity*
  • Biomarkers / blood
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Doxorubicin / therapeutic use
  • Doxorubicin / toxicity*
  • Echocardiography, Doppler*
  • Follow-Up Studies
  • Heart Diseases / chemically induced
  • Heart Diseases / diagnosis
  • Heart Function Tests
  • Humans
  • Male
  • Neoplasms / complications
  • Neoplasms / drug therapy
  • Troponin T / blood*


  • Antineoplastic Agents
  • Biomarkers
  • Troponin T
  • Doxorubicin