Выжившие после детского рака, получавшие антрациклины, имеют повышенные кардиометаболические риски

Cardiometabolic risk appeared elevated among adult survivors of childhood cancer who had been treated with anthracyclines, according to a recent study. Findings were reported in the Journal of Pediatric Hematology/Oncology. “This study demonstrates limited awareness of cardiotoxic late effects among at-risk survivors of childhood cancer,” the researchers wrote in their report. The population-based cohort study evaluated cardiotoxicity and cardiometabolic risk factors for former patients at a pediatric oncology service at the Children’s Hospital, Landspitali–University Hospital in Reykjavik, Iceland. In the study, records were retrospectively compiled for patients who had received a diagnosis before age 18 years between 1981 and 2011 and who had been treated with anthracycline-based therapy. Prior heart failure was among exclusion criteria for the study. Study participants were recruited to complete questionnaires, and for this study their medical records were linked with their self-reported information, in addition to data from clinical assessments that occurred at the Late Effects Center for adult childhood cancer survivors at the hospital. Data evaluated in the study primarily centered on childhood cancer treatment history, self-reported data, and assessments from the Late Effects Center visit. A total of 89 adult survivors were identified, among whom 60 were eligible and participated in the study. Participants’ ages ranged from 20.1 to 48.6 years (mean 29.6 years) and included 29 females and 31 males. Anthracycline cumulative doses, as doxorubicin equivalents, ranged from 40 to 780 mg/m2, with a median dose of 186.9 mg/m2 and a mean dose of 259.1 mg/m2 (SD, 187.3 mg/m2). Among the study population, 15 participants (25%) had left ventricular dilation. In most cases, this was considered mild or moderate, but it was severe for 1 participant. With 1 additional participant demonstrating reduced fractional shortening; overall, 16 participants (27%) were found to have abnormalities in left ventricular size or systolic function. In an analysis adjusted for body surface area, the prevalence of left ventricular dilation appeared to be potentially lower (5%). Additionally, 12 participants (20%) met criteria for metabolic syndrome. Overall, 15 participants (25%) were considered to have obesity, with 21 participants (35%) having overweight status. Current smoking was reported by 12 participants (20%). Echocardiography had been undergone by 41 participants (68.3%) overall, with 14 participants undergoing echocardiography within the past 5 years and 12 participants having done so within the past 6 to 10 years. However, while 23 participants (38.3%) expressed an awareness of potential late effects from their cancer treatment, just 6 (10%) named cardiac-related late effects among potential late effects. “Cardiometabolic risk factors and echocardiographic abnormalities were observed in a substantial proportion of Icelandic adult survivors treated with anthracyclines. These findings underscore the need for structured, personalized follow-up care integrating regular cardiac surveillance, cardiovascular risk assessment, and targeted survivor education,” the researchers wrote in their report. Disclosures: This research was supported in part by the Icelandic Childhood Cancer Support Association through the Children’s Hospital in Reykjavik and others. The study authors reported no conflicts of interest. Please see the original reference for a full list of disclosures.