Incidence and surveillance of acute cardiovascular toxicities in paediatric acute lymphoblastic leukaemia: A retrospective population-based single-centre cohort study
Aim: Here, we studied the incidence of acute cardiovascular toxicities in children treated for acute lymphoblastic leukaemia (ALL). Methods: We performed a population-based single-centre longitudinal retrospective cohort study in 70 children diagnosed and treated with anthracycline-containing therap...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | EJC Paediatric Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772610X23000181 |
| _version_ | 1797345864628305920 |
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| author | Maria Sjöborg Alpman Imola Toth Anette Langebäck Agneta Månsson Broberg Nikolas Herold |
| author_facet | Maria Sjöborg Alpman Imola Toth Anette Langebäck Agneta Månsson Broberg Nikolas Herold |
| author_sort | Maria Sjöborg Alpman |
| collection | DOAJ |
| description | Aim: Here, we studied the incidence of acute cardiovascular toxicities in children treated for acute lymphoblastic leukaemia (ALL). Methods: We performed a population-based single-centre longitudinal retrospective cohort study in 70 children diagnosed and treated with anthracycline-containing therapy against ALL at Karolinska University Hospital during 2015–2019 with a follow-up period of at least three months. Cardiovascular surveillance for these patients included echocardiography with measurements of left ventricular ejection fraction (LVEF) and shortening fraction (LVSF), electrocardiography and non-invasive blood pressure monitoring. Results: No patient experienced a significant decrease in LVEF or LVSF during or early after primary cancer treatment including anthracyclines. Surveillance with LVEF and LVSF was unable to predict the trajectory to severe clinical heart failure in one patient following treatment. Pericardial effusion prior to therapy initiation occurred in 13.6% of the patients. The incidence of intracardiac thrombosis and arterial hypertension was 8.5%, and 20%, respectively. Conclusion: Early cardiovascular toxicities were common in this paediatric ALL cohort. We confirm that early routine LVEF and LVSF assessments were insufficient to identify patients at risk of subsequent treatment-related heart failure. This underlines the unmet need of more sensitive methods for cardiovascular surveillance in children treated for cancer to reduce the burden of cardiovascular morbidity and mortality. |
| first_indexed | 2024-03-08T11:23:55Z |
| format | Article |
| id | doaj.art-a1f83af37e9e4036a81309c359bd96be |
| institution | Directory Open Access Journal |
| issn | 2772-610X |
| language | English |
| last_indexed | 2024-03-08T11:23:55Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EJC Paediatric Oncology |
| spelling | doaj.art-a1f83af37e9e4036a81309c359bd96be2024-01-26T05:38:34ZengElsevierEJC Paediatric Oncology2772-610X2023-12-012100020Incidence and surveillance of acute cardiovascular toxicities in paediatric acute lymphoblastic leukaemia: A retrospective population-based single-centre cohort studyMaria Sjöborg Alpman0Imola Toth1Anette Langebäck2Agneta Månsson Broberg3Nikolas Herold4Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden; Childhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden; Correspondence to: Department of Women’s and Children’s Health, Tomtebodavägen 18a, SE-171 76 Stockholm, Sweden.Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, SwedenChildhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, SwedenDepartment of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine Huddinge, Karolinska Institutet, Stockholm, SwedenAstrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden; Childhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden; Correspondence to: Department of Women’s and Children’s Health, Tomtebodavägen 18a, SE-171 76 Stockholm, Sweden.Aim: Here, we studied the incidence of acute cardiovascular toxicities in children treated for acute lymphoblastic leukaemia (ALL). Methods: We performed a population-based single-centre longitudinal retrospective cohort study in 70 children diagnosed and treated with anthracycline-containing therapy against ALL at Karolinska University Hospital during 2015–2019 with a follow-up period of at least three months. Cardiovascular surveillance for these patients included echocardiography with measurements of left ventricular ejection fraction (LVEF) and shortening fraction (LVSF), electrocardiography and non-invasive blood pressure monitoring. Results: No patient experienced a significant decrease in LVEF or LVSF during or early after primary cancer treatment including anthracyclines. Surveillance with LVEF and LVSF was unable to predict the trajectory to severe clinical heart failure in one patient following treatment. Pericardial effusion prior to therapy initiation occurred in 13.6% of the patients. The incidence of intracardiac thrombosis and arterial hypertension was 8.5%, and 20%, respectively. Conclusion: Early cardiovascular toxicities were common in this paediatric ALL cohort. We confirm that early routine LVEF and LVSF assessments were insufficient to identify patients at risk of subsequent treatment-related heart failure. This underlines the unmet need of more sensitive methods for cardiovascular surveillance in children treated for cancer to reduce the burden of cardiovascular morbidity and mortality.http://www.sciencedirect.com/science/article/pii/S2772610X23000181Acute lymphoblastic leukaemiaCardiotoxicityLate effectsEchocardiographyHypertensionThrombosis |
| spellingShingle | Maria Sjöborg Alpman Imola Toth Anette Langebäck Agneta Månsson Broberg Nikolas Herold Incidence and surveillance of acute cardiovascular toxicities in paediatric acute lymphoblastic leukaemia: A retrospective population-based single-centre cohort study EJC Paediatric Oncology Acute lymphoblastic leukaemia Cardiotoxicity Late effects Echocardiography Hypertension Thrombosis |
| title | Incidence and surveillance of acute cardiovascular toxicities in paediatric acute lymphoblastic leukaemia: A retrospective population-based single-centre cohort study |
| title_full | Incidence and surveillance of acute cardiovascular toxicities in paediatric acute lymphoblastic leukaemia: A retrospective population-based single-centre cohort study |
| title_fullStr | Incidence and surveillance of acute cardiovascular toxicities in paediatric acute lymphoblastic leukaemia: A retrospective population-based single-centre cohort study |
| title_full_unstemmed | Incidence and surveillance of acute cardiovascular toxicities in paediatric acute lymphoblastic leukaemia: A retrospective population-based single-centre cohort study |
| title_short | Incidence and surveillance of acute cardiovascular toxicities in paediatric acute lymphoblastic leukaemia: A retrospective population-based single-centre cohort study |
| title_sort | incidence and surveillance of acute cardiovascular toxicities in paediatric acute lymphoblastic leukaemia a retrospective population based single centre cohort study |
| topic | Acute lymphoblastic leukaemia Cardiotoxicity Late effects Echocardiography Hypertension Thrombosis |
| url | http://www.sciencedirect.com/science/article/pii/S2772610X23000181 |
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