Cardiomyopathies are the primary diseases of the myocardium. The most common type of them is dilated cardiomyopathy (DCM) characterized by diminished systolic functions associated with dilatation of ventricles most commonly left ventricle. Etiologies responsible for the DCM can be listed as idiopathic, genetic, viral, immune, toxins, drugs, and ischemia. Anthracyclines used for treatment of the leukemia and lymphoma have cardio toxic side effects. They are responsible from mortality and morbidity during acute, subacute, and chronic phase of the disease.

Here in we want to emphasize the importance of anthracycline toxicity that may lead to mortality and morbidity during adolescence or adult life after survival of these malignancies during childhood period.

This was a report of 5 pediatric patients who DCM detected during or after the anthracycline therapy. The ages of patients were between 8-14 years. The diagnosis of primary malignancies was lymphoma in two cases, osteosarcoma, neuroendocrine tumor, Ewing’s sarcoma in the other cases. Cumulative anthracycline dosage was between 210-480 mg/m2 (median 420 mg/m2). Time between diagnosis of DCM and administration of chemotherapy ranging between 11-34 months (median 24 months). These patients were medically stable but one patient who is referred for transplantation. All patients were receiving ACEI and diuretic treatments. Digoxin was prescribed for two patients and carvedilol for one. The mean duration of follow up was 5,5 years (2,5-9 years). One patient who diagnosed after 210 mg/m2 of anthracycline was also reviewing cyclosporine that increase toxicity of anthracycline. Left ventricular functions and dilatation was reversible in that patient.

Congestive heart failure and cardiomyopathy has been reported in patients receiving anthracycline as 4-36% and 1-30% respectively depending on treatment protocol, diagnosis, age of the patients. Systolic and diastolic functions and dimensions of the heart can be evaluated by echocardiography. Left ventricular ejection fraction and shortening fraction is the most commonly used parameters for the evaluation of the patients receiving chemotherapy but diastolic functions are effected earlier than the systolic functions. As a results diastolic parameters should also be evaluated for these patients who had or have anthracycline therapy.