Impaired vascular function in asymptomatic young adult survivors of Hodgkin Lymphoma following mediastinal radiation

Abstract

Impaired endothelial function was preferentially observed in HLS who received mediastinal radiation, while no difference was observed between the HLS and control groups overall. This finding, assessed using a non invasive test of endothelial function, confirms that mediastinal radiation is an additional cardiovascular risk factor in this young cohort of patients. Further studies of endothelial function in this patient population are warranted.

Elevated Asymmetric Dimethylarginine in Young Adult Survivors of Childhood Acute Lymphoblastic Leukemia: A Preliminary Report

“…Moreover, we are fully aware of the fact that repeated assays of ADMA and SDMA over time would strengthen prognostic implications of our findings with regard to the risk of future CV events. However, contrary to previous reports of endothelial dysfunction in childhood malignancy survivors [9,13,50], we found elevated ADMA, a biochemical marker of impaired endothelial function, in the former ALL patients who had been treated with a uniform chemotherapy protocol, which was likely to limit at least one source of data variability. Second, the percentage of selfreported smokers was insignificantly higher in the control group.…”

Carotid intima‐media thickness in young survivors of childhood cancer

“…Radiotherapy leads to morphological changes in vascular structure, ischaemic lesions in the arterial wall due to vasa vasorum injury, loss of elasticity and fibrosis. It also predisposes to chronic inflammation and endothelial cell dysfunction . Additionally, radiation directed to the cranial region affects the action of the hypothalamic‐pituitary axis of growth hormone production, which is most sensitive to radiation.…”

“…It also predisposes to chronic inflammation and endothelial cell dysfunction. [24][25][26] Additionally, radiation directed to the cranial region affects the action of the hypothalamicpituitary axis of growth hormone production, which is most sensitive to radiation. Growth hormone (GH) deficiency and pathological function of the GH-IGF axis enhance lipid disturbances, lead to obesity and insulin resistance, i.e.…”

Targeting vascular (endothelial) dysfunction

“…A similar observation was made in lymphoma survivors treated with radiotherapy – this group had a higher burden of atherosclerotic lesions and greater peripheral endothelial dysfunction than the control group (Wethal et al , ). Young adult survivors of Hodgkin Lymphoma following radiotherapy displayed impaired endothelial function as measured by peripheral arterial tonometry (PAT) (Zelcer et al , ).…”