Anu Vatanen1, Taisto Sarkola2, Tiina H Ojala2, Maila Turanlahti2, Timo Jahnukainen3, Ulla M Saarinen-Pihkala1, Kirsi Jahnukainen1,4. 1. Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 2. Division of Cardiology, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 3. Division of Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 4. Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden.
Abstract
BACKGROUND: The aim of the study was to evaluate arterial morphology and function in a national cohort of long-term survivors of high-risk neuroblastoma (NBL) treated with high-dose chemotherapy and autologous hematopoietic stem cell transplantation with or without total body irradiation (TBI). METHODS AND RESULTS: Common carotid, femoral, brachial, and radial artery morphology were assessed with very-high-resolution vascular ultrasound (25-55 MHz), and carotid artery stiffness and brachial artery flow-mediated dilatation measured with conventional vascular ultrasound in 19 adult or pubertal (age 22.7 ± 4.9 years, range 16-30) NBL survivors transplanted during 1984-1999 at the mean age of 2.5 ± 1.0 years. Results were compared with 20 age- and sex-matched healthy controls. The cardiovascular risk assessment included history, body mass index, fasting plasma lipids, glucose, and 24-h ambulatory blood pressure (BP). The survivors had consistently smaller arterial lumens, increased carotid intima-media thickness (IMT), plaque formation (N = 3), and stiffness, as well as increased radial artery intima thickness (N = 5) compared with the control group. Survivors displayed higher plasma triglyceride and cholesterol levels, and increased heart rate, as well as increased systolic and diastolic BPs. TBI (N = 10) and a low body surface area were independent predictors for decreased arterial lumen size and increased IMT. Three out of five survivors with subclinical intima thickening had arterial plaques. Plaques occurred only among TBI-treated survivors. CONCLUSIONS: Long-term childhood cancer survivors treated with TBI during early childhood display significant signs of premature arterial aging during young adulthood.
BACKGROUND: The aim of the study was to evaluate arterial morphology and function in a national cohort of long-term survivors of high-risk neuroblastoma (NBL) treated with high-dose chemotherapy and autologous hematopoietic stem cell transplantation with or without total body irradiation (TBI). METHODS AND RESULTS: Common carotid, femoral, brachial, and radial artery morphology were assessed with very-high-resolution vascular ultrasound (25-55 MHz), and carotid artery stiffness and brachial artery flow-mediated dilatation measured with conventional vascular ultrasound in 19 adult or pubertal (age 22.7 ± 4.9 years, range 16-30) NBL survivors transplanted during 1984-1999 at the mean age of 2.5 ± 1.0 years. Results were compared with 20 age- and sex-matched healthy controls. The cardiovascular risk assessment included history, body mass index, fasting plasma lipids, glucose, and 24-h ambulatory blood pressure (BP). The survivors had consistently smaller arterial lumens, increased carotid intima-media thickness (IMT), plaque formation (N = 3), and stiffness, as well as increased radial artery intima thickness (N = 5) compared with the control group. Survivors displayed higher plasma triglyceride and cholesterol levels, and increased heart rate, as well as increased systolic and diastolic BPs. TBI (N = 10) and a low body surface area were independent predictors for decreased arterial lumen size and increased IMT. Three out of five survivors with subclinical intima thickening had arterial plaques. Plaques occurred only among TBI-treated survivors. CONCLUSIONS: Long-term childhood cancer survivors treated with TBI during early childhood display significant signs of premature arterial aging during young adulthood.
Authors: A Vatanen; T H Ojala; T Sarkola; M Turanlahti; T Jahnukainen; U M Saarinen-Pihkala; K Jahnukainen Journal: Bone Marrow Transplant Date: 2016-02-01 Impact factor: 5.483
Authors: A Vatanen; M Hou; T Huang; O Söder; T Jahnukainen; M Kurimo; T H Ojala; T Sarkola; M Turanlahti; U M Saarinen-Pihkala; K Jahnukainen Journal: Bone Marrow Transplant Date: 2017-01-09 Impact factor: 5.483
Authors: Verónica Fernández-Alvarez; Fernando López; Carlos Suárez; Primoz Strojan; Avraham Eisbruch; Carl E Silver; William M Mendenhall; Johannes A Langendijk; Alessandra Rinaldo; Anne W M Lee; Jonathan J Beitler; Robert Smee; Javier Alvarez; Alfio Ferlito Journal: Strahlenther Onkol Date: 2018-04-20 Impact factor: 3.621
Authors: Donald R Dengel; Aaron S Kelly; Lei Zhang; Qi Wang; James S Hodges; Julia Steinberger; K Scott Baker Journal: Biol Blood Marrow Transplant Date: 2018-08-10 Impact factor: 5.742