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Pilot study of vascular health in survivors of Hodgkin lymphoma
Author(s) -
Mulrooney Daniel A.,
Ness Kirsten K.,
Solovey Anna,
Hebbel Robert P.,
Neaton James D.,
Peterson Bruce A.,
Lee Chung K.K.,
Kelly Aaron S.,
Neglia Joseph P.
Publication year - 2012
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.24082
Subject(s) - medicine , fibrinogen , gastroenterology , lymphoma , c reactive protein , lipoprotein , hodgkin lymphoma , apolipoprotein b , inflammation , cholesterol
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. Pediatr Blood Cancer 2012;59:285–289. © 2012 Wiley Periodicals, Inc.