• Saro H Armenian, Melissa M Hudson, Renee L Mulder, Ming Hui Chen, Louis S Constine, Mary Dwyer, Paul C Nathan, Wim J E Tissing, Sadhna Shankar, Elske Sieswerda, Rod Skinner, Julia Steinberger, Elvira C van Dalen, Helena van der Pal, W Hamish Wallace, Gill Levitt, Leontien C M Kremer, and International Late Effects of Childhood Cancer Guideline Harmonization Group.
• Department of Population Sciences, City of Hope, Duarte, USA. Electronic address: sarmenian@coh.org.
• Lancet Oncol. 2015 Mar 1; 16 (3): e123e136e123-36.

AbstractSurvivors of childhood cancer treated with anthracycline chemotherapy or chest radiation are at an increased risk of developing congestive heart failure. In this population, congestive heart failure is well recognised as a progressive disorder, with a variable period of asymptomatic cardiomyopathy that precedes signs and symptoms. As a result, several clinical practice guidelines have been developed independently to help with detection and treatment of asymptomatic cardiomyopathy. These guidelines differ with regards to definitions of at-risk populations, surveillance modality and frequency, and recommendations for interventions. Differences between these guidelines could hinder the effective implementation of these recommendations. We report on the results of an international collaboration to harmonise existing cardiomyopathy surveillance recommendations using an evidence-based approach that relied on standardised definitions for outcomes of interest and transparent presentation of the quality of the evidence. The resultant recommendations were graded according to the quality of the evidence and the potential benefit gained from early detection and intervention.Copyright © 2015 Elsevier Ltd. All rights reserved.

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