TriangleFOR PATIENTS · SOURCE READING
Radiation to the chest and certain types of chemotherapy increase the risk of heart and blood vessel late effects.
Source: Late Effects of Treatment for Childhood Cancer (PDQ®)–Patient Version, National Cancer Institute.
Source updated: February 12, 2025 · Captured 2026-09-09.
Selected source text with whitespace normalised. This Triangle page is not an NCI PDQ summary. Independent clinical review is pending.
The risk of health problems involving the heart and blood vessels increases after treatment with:
Radiation to the chest, spine, brain, neck, kidneys, or total-body irradiation (TBI) as part of a stem cell transplant. The risk of problems depends on the area of the body that was exposed to radiation, the amount of radiation given, and whether the radiation was given in small or large doses.
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Certain types of chemotherapy. Chemotherapy with anthracyclines such as doxorubicin, daunorubicin, idarubicin, and epirubicin, and with anthraquinones such as mitoxantrone increase the risk of heart and blood vessel problems. The risk of problems depends on the total dose of chemotherapy given and the type of drug used. It also depends on whether treatment with anthracyclines was given to a child younger than 13 years and whether a drug called dexrazoxane was given during treatment with anthracyclines. Dexrazoxane may lessen heart and blood vessel damage up to 5 years after treatment. Ifosfamide, cyclophosphamide, methotrexate, asparaginase, and chemotherapy with a platinum, such as carboplatin and cisplatin, may also cause heart and blood vessel late effects.
Stem cell transplant.
Nephrectomy (surgery to remove all or part of a kidney).
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Childhood cancer survivors who were treated with both radiation therapy to the heart or blood vessels and certain types of chemotherapy are at greatest risk.
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Other factors that may also increase the risk of heart and blood vessel late effects include:
Longer time since treatment.
Having high blood pressure or other risk factors for heart disease, such as a family history of heart disease, having excess body weight, smoking, high cholesterol, or diabetes. When these risk factors are combined, the risk of late effects is even higher.
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Having lower than normal amounts of thyroid, growth, or sex hormones.
New treatments that decrease the amount of radiation given, use lower doses of chemotherapy or less harmful chemotherapy drugs, and incorporate dexrazoxane may be leading to a lower risk of heart and blood vessel late effects in childhood cancer survivors.
Preserved source evidence · Independent clinical review pending · Not medical advice