Baseline studies for children receiving anthracyclines should include:

• A. Echocardiogram
• B. Brainstem auditory evoked response
• C. Pulmonary function test
• D. Creatinine clearance

Answer: (A)

Cardiotoxicity is the main concern with anthracyclines, and having a prior measure of heart function is crucial to spotting any treatment-related decline. An echocardiogram directly assesses how well the heart is pumping by measuring left ventricular function and ejection fraction, providing a concrete baseline reference before therapy begins. This makes it the key study to establish cardiac status and to monitor changes over time as the cumulative dose increases.

Hearing tests like brainstem auditory evoked response are used to detect ototoxicity from other drugs such as platinum agents, not the primary risk with anthracyclines. Pulmonary function tests would be more relevant if there were a concern for lung toxicity from agents like bleomycin, which isn’t the main issue with anthracyclines. Creatinine clearance looks at kidney function, which is important for overall care, but it doesn’t specifically monitor the dose-dependent cardiotoxic risk these drugs carry.