Endothelial dysfunction and cardiovascular risk factors in childhood acute lymphoblastic leukemia survivors

Giordano, Paola; Muggeo, Paola; Delvecchio, Maurizio; Carbonara, Santa; Romano, Alberto; Altomare, Maria; Ricci, Gabriella; Valente, F; Zito, Annapaola; Scicchitano, Pietro; Cavallo, Luciano; Ciccone, Marco Matteo; Santoro, Nicola; Faienza, Maria Felicia

doi:10.1016/j.ijcard.2016.11.025

Cited by 46 publications

(48 citation statements)

References 42 publications

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“…This finding supports the observation of Giordano et al, who also did not confirm such a correlation although concentrations of total cholesterol, triglycerides and LDL were higher, and HDL was lower in ALL survivors as compared to controls. 18 But the truth is also that we found higher HDL concentration in ALL survivors, which would have protective effect for early vascular changes in this population.…”

Section: Discussionmentioning

confidence: 71%

“…28 Our observations are in line with data published by Giordano et al They demonstrated that children after ALL treatment had lower FMD of the brachial artery but not different CIMT as compared to healthy controls. 18 Moreover, the study of Järvelä et al revealed similar results since they did not find a difference in CIMT between childhood ALL survivors aged 16-30 years as compared to controls, although it needs to be stressed that one of the main aims of their study was to compare the CIMT values before and after a 16-week home-based exercise program. 19 It should also be highlighted that most available pediatric studies regarding CIMT included older children and compared the mean values of CIMT in healthy subjects with a population at risk (hypertension, obesity, metabolic syndrome, and dyslipidemia).…”

Section: Discussionmentioning

confidence: 81%

“…Some published reports have confirmed endothelial dysfunction by showing lower flowmediated vasodilatation (FMD) but not increased CIMT in childhood ALL survivors as compared to controls. 18,19 The aim of our study was to assess the CIMT and to investigate the effects of blood pressure (BP) and lipid profile values on CIMT in childhood ALL survivors and healthy controls.…”

Section: Introductionmentioning

confidence: 99%

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CIMT does not identify early vascular changes in childhood acute lymphoblastic leukemia survivors

Ociepa¹,

Posio²,

Sawicki³

et al. 2020

Adv Clin Exp Med

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Background. Childhood acute lymphoblastic leukemia (ALL) survivors are at an increased risk of cardiovascular disease development. It is believed that in the general population, this risk can be predicted with carotid intima-media thickness (CIMT) measurement. Objectives. The objective of this study was to assess CIMT and to investigate the effects of blood pressure (BP) and lipid profile values on CIMT in childhood ALL survivors. Material and methods. The study group comprised 81 childhood ALL survivors aged 5-25 years. The control group consisted of 52 age-and sex-comparable healthy children. Carotid intima-media thickness measurement, 24-hour BP monitoring and lipid profiles were evaluated in patients and controls. Results. Despite significantly higher proportion of subjects with arterial hypertension (AH) (30/81 vs 10/52; p = 0.0315), the mean values of CIMT were not statistically different in childhood ALL survivors as compared to controls (0.4303 ±0.03 vs 0.4291 ±0.03; p = 0.81 and 1.096 ±0.74 vs 1.027 ±0.55; p = 0.56, respectively). Carotid intima-media thickness values were not statistically higher in ALL survivors with AH as compared to ALL survivors with normal BP (0.433 ±0.03 vs 0.428 ±0.03; p = 0.82). A significant positive correlation between 24-hour systolic BP standard deviation score (SDS) and CIMT-SDS in childhood ALL survivors was found (r = 0.29, p = 0.009), whereas such correlation was not observed in healthy controls (r = 0. 12, p = 0.39). A significant correlation between z-score body mass index (BMI) and CIMT was found in controls (r = 0.29, p = 0.031) but not in childhood ALL survivors (r = −0.05, p = 0.64). No significant correlations between CIMT and other measured variables were found. Carotid intima-media thickness did not significantly correlate with time since ALL diagnosis (r = 0.09, p = 0.39). Conclusions. Carotid intima-media thickness measurement shows limited feasibility and diagnostic accuracy for early assessment of vascular alteration in childhood ALL survivors. Other tests are needed to predict cardiovascular risk in childhood ALL survivors at the early stage of the follow-up.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

CIMT does not identify early vascular changes in childhood acute lymphoblastic leukemia survivors

Ociepa¹,

Posio²,

Sawicki³

et al. 2020

Adv Clin Exp Med

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“…Согласно полученным результатам, вся группа изученных пациентов подвержена высокому риску развития сосудистых осложнений, независимо от длительности и типа протокола проводимой терапии. По мнению авторов, выявленные метаболические изменения и ЭД входят в комплекс причин, обусловливающих кардиотоксическое действие цитостатиков [7].…”

Section: разное §unclassified

The Role of Endothelial Dysfunction in the Development of Cardiotoxic Action of Cytostatics in Patients with Lymphoproliferative Diseases

et al. 2019

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Understanding mechanisms of chemotherapy cardiotoxicity is an important problem due to the lack of clear understanding of its occurrence. Development of endothelial dysfunction is considered to be one of possible ways in implementation of these side effects. The analysis of endothelin-1 and e-selectin levels in 26 patients with lymphoproliferative diseases before and after the completion of the treatment program was been performed. The results of the study showed normal values of E-selectin level and increased level of endothelin-1 in the whole group of patients before treatment. After completion of chemotherapy program, in the whole group, there was a decrease of these two markers. However, values of level of endothelin-1 with vasoconstrictor effect remained high even after the end of therapy. It is imp ortant that at detailed analysis the dynamics of investigated markers in patients of older age group (median age 64 years) was associated with worsening of endothelial dysfunction.

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“…This is evidently due to the normalization of a number of NO synthetase inhibitors in children in remission [8] and the absence of pathological factors (remission of leukemia, end of treatment). It should be emphasized that children who received anthracycline drugs are at risk of cardiovascular disease even after therapy [6,9,17]. Persistence of a high NO 2 concentration and a low NO 3 concentration in the serum of patients during remission confirms incomplete endothelial recovery.…”

Section: Table 3 Correlation Relationships Between Endothelial Dysfunmentioning

confidence: 99%

Markers of Endothelial Dysfunction and Their Prognostic Value in Children With Acute Lymphoblastic Leukemia

Odinets¹,

Kondratiuk

Koida³

2020

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Acute lymphoblastic leukemia (ALL) in children is associated with development of a large number of serious complications. Inflammatory and pro-aggregation activation of endothelial cells accompanies the course of leukemia. Endothelial dysfunction (ED) is believed to be an integral part of the pathogenic link of ALL and its complications. Materials and methods. The content of nitric oxide in serum with the concentration of its stable metabolites -NO 2 , NO 3 -was determined in 73 patients with ALL and 19 healthy children. Determination of nitric oxide was performed at different stages of the presentation of ALL: 49 children were examined during the manifestation of leukemia (group 1A), of whom 36 children (group 1B) were re-examined during the first course of treatment -induction of remission. Also 8 children (group 2) were examined during supportive therapy and 16 children (group 3) who underwent complete chemotherapy treatment. Results. The study showed that nitrite increase and nitrate reduction secondary to reduced total nitric oxide content during all treatment periods in children with ALL. In addition, signs of endothelial dysfunction were recorded in patients after treatment. ROC analysis showed that reduction in NO 2 content lower than 12.31 µmol/l and the sum of NO 2 + NO 3 lower than 32.99 µmol/l significantly had a negative effect on the survival of children with ALL. Conclusions. ED accompanies the course of ALL in children. Determination of nitric oxide is of diagnostic and prognostic importance in patients with leukemia. The critical fall in the concentration of NO and NO 2 accompanies development of multiple organ failure with fatal outcome in children with ALL. Preservation of signs of ED after the end of the treatment of leukemia indicates the need for cardiac monitoring of patients with ALL in history.

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Endothelial dysfunction and cardiovascular risk factors in childhood acute lymphoblastic leukemia survivors

Cited by 46 publications

References 42 publications

CIMT does not identify early vascular changes in childhood acute lymphoblastic leukemia survivors

CIMT does not identify early vascular changes in childhood acute lymphoblastic leukemia survivors

The Role of Endothelial Dysfunction in the Development of Cardiotoxic Action of Cytostatics in Patients with Lymphoproliferative Diseases

Markers of Endothelial Dysfunction and Their Prognostic Value in Children With Acute Lymphoblastic Leukemia

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