{"id":99,"date":"2010-02-08T17:46:59","date_gmt":"2010-02-08T16:46:59","guid":{"rendered":"https:\/\/blogs.bmj.com\/heart-journalscan\/?p=99"},"modified":"2015-11-12T13:51:31","modified_gmt":"2015-11-12T12:51:31","slug":"cardiac-outcomes-in-childhood-cancer-survivors","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/heart\/2010\/02\/08\/cardiac-outcomes-in-childhood-cancer-survivors\/","title":{"rendered":"Cardiac Outcomes in Childhood Cancer Survivors"},"content":{"rendered":"

Therapeutic advances in paediatric oncology have led to an increase in the number of adult survivors of childhood cancers.\u00a0 However, it is not currently known whether their long term health is influenced by the cancer therapies they receive.<\/p>\n

In this retrospective cohort study, 14358 five year survivors of cancer enrolled in the Childhood Cancer Survivor Study were studied.\u00a0 All had been diagnosed under the age of 21 with leukaemia, brain cancer, Hodgkin\u2019s lymphoma, non-Hodgkin\u2019s lymphoma, kidney cancer, neuroblastoma, soft tissue sarcoma, or bone cancer between 1970 and 1986.\u00a0 A comparison group consisted of 3899 siblings of cancer survivors.\u00a0 The main outcome measures studied were the incidence of and risk factors for congestive heart failure, myocardial infarction, pericardial disease, and valvular abnormalities in survivors of cancer compared with siblings.<\/p>\n

The cumulative incidence of cardiac disorders among childhood cancer survivors are shown in figure 1.\u00a0 Overall, the cumulative incidence of adverse cardiac outcomes in cancer survivors continued to increase up to 30 years after diagnosis.<\/p>\n

http:\/\/heart.bmj.com\/site\/misc\/March2.pdf<\/a><\/p>\n

Figure 1: Cumulative incidence of various cardiac disorders among childhood cancer survivors<\/p>\n

Survivors of cancer were significantly more likely than their siblings to report congestive heart failure (hazard ratio (HR) 5.9, p<0.001), myocardial infarction (HR 5.0, p<0.001), pericardial disease (HR 6.3, p<0.001) or valvular abnormalities (HR 4.8, P<0.001).\u00a0 In particular, exposure to >250mg\/m2 of anthracyclines increased the relative hazard of congestive heart failure, pericardial disease, and valvular abnormalities by two to five times compared with survivors who had not been exposed to anthracyclines.\u00a0 Also, cardiac radiation exposure (>1500 centigray) increased the relative hazard of all four abnormalities by between two- and sixfold compared to non-irradiated survivors.<\/p>\n

Conclusions:<\/p>\n

A substantial risk for all forms of cardiovascular disease is present in survivors of childhood and adolescent cancers.\u00a0 As this population continues to grow, all healthcare professionals must be aware of the increased cardiovascular risk of this group of patients.<\/p>\n

\u2022\u00a0\u00a0\u00a0 Mulrooney DA, Yeazel MW, Kawashima T et al.\u00a0 Cardiac outcomes in a cohort of adult survivors of childhood adolescent cancer: retrosepective analysis of the Childhood Cancer Survivor Study Cohort.\u00a0 BMJ 2009 online first<\/p>\n","protected":false},"excerpt":{"rendered":"

Therapeutic advances in paediatric oncology have led to an increase in the number of adult survivors of childhood cancers.\u00a0 However, it is not currently known whether their long term health is influenced by the cancer therapies they receive. […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":103,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[279],"tags":[],"class_list":["post-99","post","type-post","status-publish","format-standard","hentry","category-general-cardiology"],"yoast_head":"\nCardiac Outcomes in Childhood Cancer Survivors - Heart<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/heart\/2010\/02\/08\/cardiac-outcomes-in-childhood-cancer-survivors\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cardiac Outcomes in Childhood Cancer Survivors - Heart\" \/>\n<meta property=\"og:description\" content=\"Therapeutic advances in paediatric oncology have led to an increase in the number of adult survivors of childhood cancers.\u00a0 However, it is not currently known whether their long term health is influenced by the cancer therapies they receive. 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