Document Detail


Increased prevalence of risk factors for cardiovascular disease in long-term survivors of acute lymphoblastic leukemia and Wilms tumor treated with radiotherapy.
MedLine Citation:
PMID:  20589650     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Only a few studies have assessed cardiovascular risk factors (CRFs) in childhood cancer survivors. We determined the prevalence of CRFs in long-term survivors of acute lymphoblastic leukemia (ALL) and Wilms tumor. PROCEDURE: Adult survivors of ALL and Wilms tumor treated with radiotherapy and chemotherapy (RT + CT) or treated with chemotherapy alone (CT) were compared with sibling controls. CRFs (hypertension, diabetes mellitus, hypercholesterolemia, obesity, renal insufficiency) and hormonal deficiencies were assessed in each participant. Multivariate logistic regression analysis was used to evaluate the association between CRFs and treatment. RESULTS: Seventy-nine ALL, 62 Wilms tumor survivors, and 69 control subjects (mean ages 24.5, 25.9, and 26 years, respectively) were enrolled. Mean follow-up time since cancer treatment was 20.8 years. In the Wilms RT + CT group significantly more survivors had hypertension (21.6% vs. 1.4%, P < 0.001) and renal insufficiency (8.1% vs. 0%, P = 0.016) compared to controls. There were also more patients with multiple CRFs in the Wilms RT + CT group (16.2% vs. 2.9% in controls, P = 0.019). Almost 15% of ALL RT + CT survivors had growth hormone deficiency. Hypogonadism was seen in 18.9% of survivors in the Wilms RT + CT group. We observed no significant differences between CT-treated survivors of both malignancies and controls. The adjusted odds ratio for the occurrence of at least one CRF was 2.6 increased for survivors following abdominal radiotherapy. Treatment with CT alone was not associated with the occurrence of multiple CRFs. CONCLUSIONS: Long-term survivors of ALL and Wilms tumor have unfavorable CRFs due to previous RT not CT.
Authors:
M M Geenen; P J M Bakker; L C M Kremer; J J P Kastelein; F E van Leeuwen
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric blood & cancer     Volume:  55     ISSN:  1545-5017     ISO Abbreviation:  Pediatr Blood Cancer     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-08-31     Completed Date:  2010-09-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101186624     Medline TA:  Pediatr Blood Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  690-7     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Wiley-Liss, Inc.
Affiliation:
Outpatient Clinic of Late Effects Following Childhood Cancer, Emma Children's Hospital/Academic Medical Center (EKZ/AMC), Amsterdam, The Netherlands. m.geenen@slaz.nl
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cardiovascular Diseases / etiology*
Child
Child, Preschool
Humans
Infant
Infant, Newborn
Kidney Neoplasms / complications*,  mortality,  therapy
Lipids / blood
Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*,  mortality,  therapy
Prevalence
Risk Factors
Survivors
Wilms Tumor / complications*,  mortality,  therapy
Chemical
Reg. No./Substance:
0/Lipids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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