2023 Fiscal Year Final Research Report
Establishment of early detection methods for lethal arrhythmia related to anticancer drugs in pediatric cancer survivors
| Project/Area Number |
20K16928
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 52050:Embryonic medicine and pediatrics-related
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| Research Institution | Oita University |
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Principal Investigator |
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| Project Period (FY) |
2020-04-01 – 2024-03-31
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| Keywords | 心室再分極 / Tpeak-end/QT / 致死性不整脈 / 学校心臓検診 / 小児急性リンパ芽急性白血病 |
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| Outline of Final Research Achievements |
We retrospectively summarized the Tpe interval, QT interval,QTc interval, and Tpe/QT ratio in healthy Japanese children. Electrocardiography data recorded from students in 1st and 7th grades were randomly selected from a database maintained by the school-based screening system in the Oita city cohort, Japan.Subsequently, chronological data of the Tpe/QT ratio in 17 pediatric patients with acute lymphoblastic leukemia were analyzed over time.The mean ± standard deviation of the Tpe interval in 1st and 7th graders was 70 ± 7 and 78 ± 17 ms,respectively, while the mean ± standard deviation of the Tpe/QT ratio was 0.21 ± 0.02 and 0.22 ± 0.02 ms, respectively. During the intensive phase of treatment, the Tpe/QT ratios of 3 high-risk patients among the 17 patients with acute lymphoblastic leukemia exceeded the upper limit.
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| Free Research Field |
小児循環器
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| Academic Significance and Societal Importance of the Research Achievements |
まず、日本人小児の心室性不整脈の予測因子としての心室再分極指標（Tpeak-end、Tpeak-end/QT）の基準値の報告は世界初である。そして、Tpeak-end/QTが年齢、性別によらない良い指標であることを確認した。疾患への臨床応用としては、小児急性リンパ芽急性白血病患者ではアドリアマイシン等の抗がん化学療法によって心筋障害を呈し、致死性不整脈のリスクが急性期に一過性に高くなっている可能性が示唆された。よって、白血病を含めた小児がん経験者における同指標による合併症の検討が今後の疾患フォローアップや治療プロトコールの検証に有用である可能性が考えられ、さらなる大多数の検討が望まれる。
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