The use of anthracyclines in the treatment of malignities in children is restricted by their cardiotoxicity which may lead to dilated or restrictive cardiomyopathy. Early cardiotoxicity occurs at the age under one year after terminated treatment. The main cause is impaired contractile ability of the left ventricle caused by damage or death of myocytes. Risk factors include the level of the cumulative dose, the level of individual bolus doses, female sex, black race, amsacrin administration and trisomy on the 21st chromosome. Late cardiotoxicity occurs during the period longer than one year after completed treatment. It develops as a result of an excessive afterload while the ventricular wall is thinner and the contractility is impaired.Animportant risk factor is young age of the child at the time when chemotherapy was administered and the interval after completed treatment. The reported incidence of cardiotoxicity is 1 - 2 %, clinical signs of late cardiotoxicity during the first decade after chemotherapy are described in 5 - 10%. Although anthracycline treatment significantly improved survival of patients treated in childhood on account of a malignity, cardiac complications must be foreseen in future. This pertains in particular to patients who were treated years ago with high cumulative anthracycline doses. To what extent late cardiotoxicity will influence the survival of oncological patients in the second and third decade after chemotherapy will be revealed by long-term prospective studies.

        Key words: anthracyclines, cardiotoxicity, risk factors