الفهرس 
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Abstract
Children suffering from malignancies represent a growing cohort of our society. Fortunately, we are witnessing great improvements in management of patients suffering from childhood cancer, including early diagnosis, multimodal therapy and hospital supportive care. These improvements eventually lead to increasing the survival rate and treatment outcome of patients suffering of cancer.
Cardiovascular disease is one of the leading causes of morbidity and mortality in long-term cancer survivors. Cardiovascular complications related to cancer treatment may arise after long time of end of therapy. So it is very important to regularly follow up survivors for early detection and management of such conditions.
Cardiac dysfunction, in childhood cancer survivors, related to anthracycline treatment is initially subclinical and unfortunately passes unnoticed in regular cardiac assessment by conventional echocardiographic methods. Early detection of cardiac dysfunction plays a crucial in management of the condition before developing a life threatening health issue. Therefore, it is becoming a priority for oncologists to develop new modalities and techniques directed for early detection of subclinical cardiac dysfunction. NT-proBNP measurement are giving and impressing results regarding cardiac assessment in childhood cancer survivors.
The aim of this work was to :
Study Cardiac abnormalities using plasma N-terminal pro brain natriuretic peptide (NT-proBNP) and echocardiography in asymptomatic childhood cancer survivors caused by the received cardiotoxic drugs during their treatment.
Patients were subjected to the followings:
1. Full history taking.
2. Thorough clinical examination.
3. Laboratory evaluation in the form of (CBC, liver and kidney function tests, iron and lipid profile, electrolytes , fasting blood sugar level) and NT-proBNP analysis.
4. Cardiac imaging assessment by conventional 2D echocardiograpy.
Results showed that:
Most of the survivors (25 children) were diagnosed as ALL, 8 as NHL and 7 as HL. Their age at diagnosis of cancer ranged between 2 and 16 years. All of our survivors were treated with anthracycline based protocols of chemotherapy and the cumulative dose of anthracycline ranged between 75 and 400 mg/m2.
The weight and BMI of the survivors were statistically higher than that of the control group indicates the prevalence of obesity and overweight among survivors while regarding height, it was significantly lower in the survivors group than the control group. Regarding the blood pressure, the systolic and diastolic blood pressures were significantly higher in the survivors group than the control group while there was no significant difference regarding heart rate.
Regarding laboratory investigations of both groups, Hb, HCT, TIBC, transferrin saturation, D. Billirubin, T. Billirubin, Ca, K, Na, Albumin, BUN and Creatinine were of no significant difference between survivors and control but ALT, AST, serum iron, serum ferritin and fasting glucose level were significantly higher in the survivors group more than the control. Regarding the lipid profile, serum Cholesterol, TGs and LDL were significantly higher in survivors while serum HDL were significantly lower in the survivors group more than the control group.