ReviewSystematic review and updated recommendations forcardiomyopathy surveillance for survivors of childhood,adolescent,and young adult cancer from the InternationalLate Effects of Childhood Cancer Guideline HarmonizationGroupMatthew J Ehrhardt"Jan M Leerink"ReneeL Mulder,Annelies Mavinkurve-Groothuis,Wouter Kok,Anju Nohria,Paul CNathan,Remy MerkxEsmee de Baat,Ogechukwu A Asogwa,Roderick Skinner,Hamish Wallace,E A M Lieke Feijen,Maille de Villede Goyet,Maya Prasad Edit Bardi,Vesna Pavasovic,Helena van der Pal Brice Fresneau,Charlotte Demoor-Goldschmidt,Ulrike Hennewig,Julia Steinberger,Chris Plummer,Ming Hui Chen,Arco J Teske Nadia Haddy,Elvira C van Dalen Louis S Constine,Eric JChow,Gill Levitt,Melissa M Hudson,Leontien C M Kremert,Saro H ArmeniantSurvivors of childhood,adolescent,and young adult cancer,previously treated with anthracycline chemotherapyLancetOncol 2023:24:e108-20(induding mitoxantrone)or radiotherapy in which the heart was exposed,are at increased risk of cardiomyopathy.Published OnlineSymptomatic cardiomyopathy is typically preceded by a series of gradually progressive,asymptomatic changes inFebruary 14,2023structure and function of the heart that can be ameliorated with treatment,prompting specialist organisations tohttps//doiorg/101016/514702045(2300012-8endorse guidelines on cardiac surveillance in at-risk survivors of cancer.In 2015,the International Late Effects ofChildhood Cancer Guideline Harmonization Group compiled these guidelines intoa uniform set of recommendationsJoint first authorsapplicable to a broad spectrum of clinical environments with varying resource availabilities.Since then,additionaltjoint lst authosstudies have provided insight into dose thresholds associated with a risk of asymptomatic and symptomaticDepartment ofOncology andDepartment of Epidemiologycardiomyopathy,have characterised risk over time,and have established the cost-effectiveness of different surveillanceand Cancer Controlst ludestrategies.This systematic Review and guideline provides updated recommendations based on the evidence published children's ResecHoitup to September,2020.Memphis,TN,USA(M JEhrhardt MD MS,IntroductionProf M MHudson MD):Princessto identify risk over time,and established the cost.Mixima Center for PediatricSurvivors of childhood,adolescent,and young adulteffectiveness of different surveillance strategies.In thisOncology,Utrecht,(CAYA)cancer who have been previously exposed toReview,we assessed and graded the quality of studiesNetherlands (J MLeerink MD,anthracycline chemotherapy or the anthraquinoneincluded in the previous IGHG guideline and thoseR LMulderPhD,A Mavinikurve-Groothuis MDmitoxantrone (both of which are hereafter referred to aspublished since,summarised available evidence,andE de Baat MD,OA AsogwaMD,anthracycline),or radiotherapy in which the heart wasformulated recommendations supported by these data.EA M Lieke Fei可en PhD,exposed,are at increased risk for heart failure.SurvivorsH vander Pal MD,ECvan Dale
