Anthracyclines: cardiotoxicity and its prevention.

The anthracycline antibiotics have now been in use in curative chemotherapy protocols for over two decades. They are highly active against a wide range of haemopoietic and solid tumours in children and adults. Unfortunately, their antineoplastic use is limited by significant and irreversible cardiotoxicity, the full extent of which continues to emerge. As more children become long term survivors of cancer, the relative impact of anthracycline induced cardiac damage has increased but, despite an understanding of the pathogenesis, consensus strategies for detection and prevention have not been established.