Pilot study of vascular health in survivors of Hodgkin lymphoma.

Pubmed ID: 22457206

Pubmed Central ID: PMC3374066

Journal: Pediatric blood & cancer

Publication Date: Aug. 1, 2012

Affiliation: School of Public Health, Masonic Cancer Center, and University of Minnesota Medical School, Minneapolis, Minnesota 55455, USA. mulro006@umn.edu

MeSH Terms: Humans, Male, Adult, Female, Case-Control Studies, Adolescent, Middle Aged, Young Adult, Child, Follow-Up Studies, Survival Rate, Cholesterol, HDL, Triglycerides, Cholesterol, LDL, Child, Preschool, Fibrinogen, C-Reactive Protein, Inflammation, Pilot Projects, Hodgkin Disease, Lipoprotein(a), Neoplasm Staging, Radiotherapy Dosage, Survivors, Vascular Cell Adhesion Molecule-1, Vascular Diseases, Biomarkers

Grants: 1K12RR023247, 5P01HL055552-13, K12 RR023247, K12 RR023247-04, P01 HL055552, P01 HL055552-13

Authors: Mulrooney DA, Ness KK, Solovey A, Hebbel RP, Neaton JD, Peterson BA, Lee CK, Kelly AS, Neglia JP

Cite As: Mulrooney DA, Ness KK, Solovey A, Hebbel RP, Neaton JD, Peterson BA, Lee CK, Kelly AS, Neglia JP. Pilot study of vascular health in survivors of Hodgkin lymphoma. Pediatr Blood Cancer 2012 Aug;59(2):285-9. Epub 2012 Mar 27.

Studies:

Coronary Artery Risk Development in Young Adults (CARDIA)

Abstract

BACKGROUND: Vascular-related toxicities have been reported among survivors of Hodgkin lymphoma (HL), but their genesis is not well understood. PROCEDURE: Fasting blood samples from 25 previously irradiated HL survivors were analyzed for biomarkers that can reveal underlying inflammation and/or endothelial cell activation: high-sensitivity C-reactive protein (hsCRP), triglycerides, total cholesterol, high-density lipoprotein (HDL), apolipoprotein ß, lipoprotein (a), fibrinogen, circulating endothelial cells (CECs), and vascular cell adhesion molecule-1 (VCAM-1) expression. Values were compared to subjects in the Coronary Artery Risk Development in Young Adults (CARDIA) study. CECs and VCAM-1 were compared to healthy controls. RESULTS: Survivors (76% male), median age 17.6 years (5-33) at diagnosis, 33.0 years (19-55) at follow-up, included stages IA (n = 6), IIA (n = 10), IIB (n = 2), IIIA (n = 4), and IVA (n = 3) patients. Twenty-four received at least chest radiation therapy (RT) (median dose 3,150 cGy; range: 175-4,650 cGy), one received neck only; 14 (56%) had a history of anthracycline exposure (median dose: 124 mg/m(2) range: 63-200 mg/m2). Compared to CARDIA subjects, mean hsCRP (3.0 mg/L ± 2.0 vs. 1.6 ± 1.9), total cholesterol (194.1 mg/dl ± 33.2 vs. 179.4 ± 32.9), lipoprotein (a) (34.2 mg/dl ± 17.5 vs. 13.8 ± 17.5), and fibrinogen (342.0 mg/dl ± 49.1 vs. 252.6 ± 48.4) were significantly elevated. CECs (2.3 cells/ml ± 1.5 vs. 0.34 ± 1.4) were significantly elevated compared to controls. No difference in VCAM-1 expression (51.1% ± 36.8 vs. 42.3 ± 35.6) was detected. CONCLUSION: HL survivors exposed to RT have evidence of vascular inflammation, dyslipidemia, and injury suggestive of early atherogenesis.