Afterload Reduction Therapy for Late Anthracycline Cardiotoxicity: A Pediatric Oncology Group Cancer Control Study

Inclusion Criteria

DISEASE CHARACTERISTICS: Histologically diagnosed childhood malignancy that had prior
anthracycline therapy Echocardiographic evidence of reduced fractional shortening, reduced
contractility, or increased afterload, or any combination At least 6 months oncologic
disease free

PATIENT CHARACTERISTICS: Age: At least 8 at study entry and less than 22 at diagnosis
Performance status: Not specified Life expectancy: Not specified Hematopoietic: Not
specified Hepatic: Not specified Renal: No history of renal disease No known renal artery
stenosis Cardiovascular: No congenital cardiovascular malformations No active congestive
heart failure not attributable to sepsis or renal failure No medication for heart
condition No history of symptomatic arrhythmia antedating anthracycline therapy No
constrictive pericarditis No uncontrolled hypertension Pulmonary: No primary valvular or
outflow tract obstruction Other: Not pregnant or lactating Must use adequate contraception
No reaction or intolerance to ACE inhibitors

PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: At least 1 year
since prior cumulative anthracycline therapy of at least 200 mg/m2 No prior amsacrine
therapy Endocrine therapy: Not specified Radiotherapy: No prior mediastinal, spinal, or
total body irradiation that included the heart Surgery: Not specified Other: No concurrent
angiotensin converting enzyme (ACE)inhibitor treatment No concurrent treatment with other
investigational drug No oncologic therapy within past 6 months