Pregnancy-associated cardiomyopathy in survivors of childhood cancer.

Published on Feb 1, 2016in Journal of Cancer Survivorship4.442
· DOI :10.1007/S11764-015-0457-8
Melissa R. Hines1
Estimated H-index: 1
(UNC: University of North Carolina at Chapel Hill),
Daniel A. Mulrooney35
Estimated H-index: 35
(UTHSC: University of Tennessee Health Science Center)
+ 5 AuthorsMonika L. Metzger38
Estimated H-index: 38
(UTHSC: University of Tennessee Health Science Center)
Sources
Abstract
Purpose Current information regarding pregnancy-associated cardiomyopathy among women treated for childhood cancer is insufficient to appropriately guide counseling and patient management. This study aims to characterize its prevalence within a large cohort of females exposed to cardiotoxic therapy.
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17 Authors (Melissa M. Hudson)
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#1Kathleen Stergiopoulos (SBU: Stony Brook University)H-Index: 15
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To varying extents, women with pre-existing cardiomyopathies have a limited cardiovascular reserve. The hemodynamic challenges of pregnancy, labor, and delivery pose unique risks to this group of patients, which can result in clinical decompensation with overt heart failure, arrhythmias, and rarely, maternal death. A multidisciplinary team approach and a controlled delivery are crucial to adequate management of patients with underlying heart disease. Pre-conception planning and risk assessment a...
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With the improvement in survival from childhood cancer, late effects of therapy are becoming more apparent. Cardiac disease, one of these late effects, has a significant impact on the life of survivors of childhood cancers. Most survivors are followed by primary care doctors and adult subspecialists after they have graduated from pediatric centers. Since much of the cardiac toxicity of therapy occurs years off of therapy, it is important for these physicians to be aware of how to monitor survivo...
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#1Melissa M. Hudson (UT: University of Tennessee)H-Index: 35
#2Kirsten K. Ness (St. Jude Children's Research Hospital)H-Index: 84
Last. Leslie L. Robison (St. Jude Children's Research Hospital)H-Index: 154
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Background To facilitate prospective medical assessment of adults surviving pediatric malignancies and advance knowledge about long-term childhood cancer survivor health, St. Jude Children's Research Hospital (SJCRH) is establishing a lifetime cohort of survivors. Methods Eligibility criteria for inclusion in the St. Jude Lifetime Cohort (SJLIFE) study include: (1) diagnosis of childhood malignancy treated at SJCRH; (2) survival ≥ 10 years from diagnosis; and (3) current age ≥18 years. Three lev...
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#1Daniel A. Mulrooney (UMN: University of Minnesota)H-Index: 35
#2Mark W. YeazelH-Index: 25
Last. Wendy M. Leisenring (Fred Hutchinson Cancer Research Center)H-Index: 109
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Objectives To assess the incidence of and risks for congestive heart failure, myocardial infarction, pericardial disease, and valvular abnormalities among adult survivors of childhood and adolescent cancers. Design Retrospective cohort study. Setting 26 institutions that participated in the Childhood Cancer Survivor Study. Participants 14 358 five year survivors of cancer diagnosed under the age of 21 with leukaemia, brain cancer, Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, kidney cancer, neurob...
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#1Torgeir Wethal (University of Oslo)H-Index: 10
#2May Brit Lund (University of Oslo)H-Index: 25
Last. Alexander FossåH-Index: 28
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Valvular dysfunction and left ventricular changes in Hodgkin's lymphoma survivors. A longitudinal study
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#1Gregory T. Armstrong (St. Jude Children's Research Hospital)H-Index: 67
#2Qi LiuH-Index: 28
Last. Ann C. MertensH-Index: 58
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The Childhood Cancer Survivor Study (CCSS) has assembled the largest cohort to date for assessment of late mortality. Vital status and cause of death of all patients eligible for participation in CCSS was determined using the National Death Index and death certificates to characterize the mortality experience of 20,483 survivors, representing 337,334 person-years of observation. A total of 2,821 deaths have occurred as of December 31, 2002. The overall cumulative mortality is 18.1% (95% CI, 17.3...
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#5M. Crump (U of T: University of Toronto)H-Index: 20
Age- and sex-specific estimates of the rate of cardiac morbidity among Hodgkin lymphoma (HL) patients treated with doxorubicin-based chemotherapy and radiation therapy (RT) are scarce. We evaluated the risk of hospital admission for cardiac disease in 615 HL patients, adjusting for age, sex, treatment, cardiac risk factors and competing causes of death. Compared with the general population, the risk of cardiac morbidity was highest among patients treated with both doxorubicin and mediastinal RT ...
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#1Berthe M.P. Aleman (NKI-AVL: Netherlands Cancer Institute)H-Index: 51
#2Alexandra W. van den Belt-Dusebout (NKI-AVL: Netherlands Cancer Institute)H-Index: 14
Last. Flora E. van Leeuwen (NKI-AVL: Netherlands Cancer Institute)H-Index: 84
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We assessed cardiovascular disease (CVD) incidence in 1474 survivors of Hodgkin lymphoma (HL) younger than 41 years at treatment (1965-1995). Multivariable Cox regression and competing risk analyses were used to quantify treatment effects on CVD risk. After a median follow-up of 18.7 years, risks of myocardial infarction (MI) and congestive heart failure (CHF) were strongly increased compared with the general population (standardized incidence ratios [SIRs] = 3.6 and 4.9, respectively), resultin...
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Results A total of 166 deaths from myocardial infarction occurred in the cohort, statistically significantly more than expected (standardized mortality ratio [SMR] = 2.5, 95% confidence interval [CI] = 2.1 to 2.9), with an absolute excess risk of 125.8 per 100 000 person-years. Standardized mortality ratios decreased sharply with older age at first treatment, but absolute excess risks of death from myocardial infarction increased with older age up to age 65 years at first treatment. The statisti...
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#5Huib N. Caron (UvA: University of Amsterdam)H-Index: 42
Abstract The cumulative incidence of peripartum anthracycline-induced clinical heart failure (A-CHF) was evaluated in a cohort of 53 childhood cancer survivors who had delivered one or more children. None of them developed peripartum A-CHF (cumulative incidence 0%; 95% confidence interval (CI) 0–5.7%). The mean follow-up time after the first administration of anthracycline therapy was 20.3 years. They received a mean cumulative anthracycline dose of 267mg/m 2 . It is worth noticing that even 2 p...
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Recent advances in cancer therapies have enabled many women diagnosed with malignancies during childhood and adolescence to survive longer and therefore to reach an age where they wish to conceive. When providing cancer treatment such as anticancer drugs and radiotherapy, attention is often paid to preserving future fertility, but little is known about maternal pregnancy risks, and in particular cardiovascular complications. Recent studies have shown that cardiovascular diseases such as cardiomy...
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#4Carlos E. Rochitte (USP: University of São Paulo)H-Index: 55
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This position paper focusses on the pathophysiology, diagnosis and management of women diagnosed with a cardiomyopathy, or at risk of heart failure (HF), who are planning to conceive or present with (de novo or previously unknown) HF during or after pregnancy. This includes the heterogenous group of heart muscle diseases such as hypertrophic, dilated, arrhythmogenic right ventricular and non-classified cardiomyopathies, left ventricular non-compaction, peripartum cardiomyopathy, Takotsubo syndro...
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#2Giorgia MangiliH-Index: 23
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Abstract While cancer during pregnancy and its treatment has grown to be a popular topic in recent years, little is known on how to advise patients looking to conceive or conceiving after cancer treatment. The aim of this paper is to review the available literature on the impact of pregnancy on survivors of the most common childhood cancers, brain cancer, haematological malignancies, thyroid cancer, melanomas and sarcomas. Its main objective is to be a source of information for clinicians lookin...
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#1Mark Nolan (UHN: University Health Network)H-Index: 5
Abstract Background Cancer treatment can lead to left ventricular (LV) dysfunction in female cancer survivors of reproductive age, and pregnancy-related hemodynamic stress may result in LV dysfunction or heart failure (HF). Objectives The authors performed a systematic review and meta-analysis to determine the incidence of LV systolic dysfunction or HF during or soon after pregnancy in cancer survivors and evaluated the impact of history of cancer therapeutics-related cardiac dysfunction (CTRCD)...
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