Late-onset cardiomyopathy among survivors of childhood lymphoma treated with anthracyclines: a systematic review

Benetou, Despoina-Rafailia; Stergianos, Evangelos; Geropeppa, Maria; Ntinopoulou, Erato; Tzanni, Marina; Pourtsidis, Apostolos; Petropoulos, Andreas; Georgakis, Marios K.; Tousoulis, Dimitrios; Petridou, Eleni

doi:10.1016/j.hjc.2018.09.004

Cited by 6 publications

(10 citation statements)

References 65 publications

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“…Second, contrary to Smitherman et al’s study, we did not identify a high rate of antihypertensive use in our cohort. Cardiovascular morbidities are more prevalent in survivors of lymphoma who are treated with high-dose anthracyclines and thoracic radiation ( 4 , 27 , 28 ). The higher proportion of lymphoma survivors in Smitherman et al’s study cohort (26.4%) than in our study cohort (11.2%) may explain this difference.…”

Section: Discussionmentioning

confidence: 99%

Use of Chronic Prescription Medications and Prevalence of Polypharmacy in Survivors of Childhood Cancer

et al. 2021

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BackgroundAs survivors of childhood cancer age, development of cancer treatment-related chronic health conditions often occur. This study aimed to describe the pattern of chronic prescription medication use and identify factors associated with polypharmacy among survivors of childhood cancer.MethodsThis was a retrospective study conducted at the pediatric oncology long-term follow-up clinic in Hong Kong. Eligible subjects included survivors who were (1) diagnosed with cancer before 18 years old, (2) were at least 3 years post-cancer diagnosis and had completed treatment for at least 30 days, and (3) receiving long-term follow-up care at the study site between 2015 and 2018. Dispensing records of eligible survivors were reviewed to identify medications taken daily for ≥30 days or used on an “as needed” basis for ≥6 months cumulatively within the past 12-month period. Polypharmacy was defined as the concurrent use of ≥5 chronic medications. Multivariable log-binomial modeling was conducted to identify treatment and clinical factors associated with medication use pattern and polypharmacy.ResultsThis study included 625 survivors (mean current age = 17.9 years, standard deviation [SD] = 7.2 years) who were 9.2 [5.2] years post-treatment. Approximately one-third (n = 219, 35.0%) of survivors were prescribed at least one chronic medication. Frequently prescribed medication classes include systemic antihistamines (26.5%), sex hormones (19.2%), and thyroid replacement therapy (16.0%). Overall prevalence of polypharmacy was 5.3% (n = 33). A higher rate of polypharmacy was found in survivors of CNS tumors (13.6%) than in survivors of hematological malignancies (4.3%) and other solid tumors (5.3%) (P = .0051). Higher medication burden was also observed in survivors who had undergone cranial radiation (RR = 6.31; 95% CI = 2.75–14.49) or hematopoietic stem-cell transplantation (HSCT) (RR = 3.53; 95% CI = 1.59–7.83).ConclusionAlthough polypharmacy was observed in a minority of included survivors of childhood cancer, chronic medication use was common. Special attention should be paid to survivors of CNS tumors and survivors who have undergone HSCT or cranial radiation. These individuals should be monitored closely for drug–drug interactions and adverse health outcomes that may result from multiple chronic medications, particularly during hospitalization in an acute care setting.

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Section: Discussionmentioning

confidence: 99%

Use of Chronic Prescription Medications and Prevalence of Polypharmacy in Survivors of Childhood Cancer

et al. 2021

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“…Temporal trends in EF/SF suggest that dexrazoxane may also decrease later cardiotoxicity, 19 a leading cause of late morbidity and non-relapse-related mortality in pediatric cancer survivors. 5,[7][8][9][10] Still, efforts should be made to acquire additional follow-up on cardiac outcomes to fully assess the long-term impacts of dexrazoxane use. While highly effective, dexrazoxane did not provide complete protection against EF/SF declines.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] However, anthracyclines increase both early-and late-term cardiotoxicity. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Anthracyclines generate iron-mediated free radicals when metabolized by the mitochondria, which triggers myocardial cell death and left ventricular systolic dysfunction (LVSD). 14,21,22 Anthracyclines also intercalate DNA by binding topoisomerase IIb, which is abundant in cardiomyocytes, thus inhibiting DNA replication and increasing apoptosis to induce LVSD.…”

Section: Introductionmentioning

confidence: 99%

Effect of Dexrazoxane on Left Ventricular Systolic Function and Treatment Outcomes in Patients With Acute Myeloid Leukemia: A Report From the Children’s Oncology Group

Getz

Sung

Alonzo

et al. 2020

JCO

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PURPOSE To determine whether dexrazoxane provides effective cardioprotection during frontline treatment of pediatric acute myeloid leukemia (AML) without increasing relapse risk or noncardiac toxicities of the chemotherapy regimens. PATIENTS AND METHODS This was a multicenter study of all pediatric patients with AML without high allelic ratio FLT3/ITD treated in the Children’s Oncology Group trial AAML1031 between 2011 and 2016. Median follow-up was 3.5 years. Dexrazoxane was administered at the discretion of treating physicians and documented at each course. Ejection fraction (EF) and shortening fraction (SF) were recorded after each course and at regular intervals in follow-up. Per protocol, anthracyclines were to be withheld if there was evidence of left ventricular systolic dysfunction (LVSD) defined as SF < 28% or EF < 55%. Occurrence of LVSD, trends in EF and SF, 5-year event-free survival (EFS) and overall survival (OS), and treatment-related mortality (TRM) were compared by dexrazoxane exposure. RESULTS A total of 1,014 patients were included in the analyses; 96 were exposed to dexrazoxane at every anthracycline course, and 918 were never exposed. Distributions of sex, age, race, presenting WBC count, risk group, treatment arm, and compliance with cardiac monitoring were similar for dexrazoxane-exposed and -unexposed patients. Dexrazoxane-exposed patients had significantly smaller EF and SF declines than unexposed patients across courses and a lower risk for LVSD (26.5% v 42.2%; hazard ratio, 0.55; 95% CI, 0.36 to 0.86; P = .009). Dexrazoxane-exposed patients had similar 5-year EFS (49.0% v 45.1%; P = .534) and OS (65.0% v 61.9%; P = .613) to those unexposed; however, there was a suggestion of lower TRM with dexrazoxane (5.7% v 12.7%; P = .068). CONCLUSION Dexrazoxane preserved cardiac function without compromising EFS and OS or increasing noncardiac toxicities. Dexrazoxane should be considered for cardioprotection during frontline treatment of pediatric AML.

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“…Cluster 3 of the cohesive analysis was labeled cancer treatment and complication because the main keywords were matched with topics 4 and 7 of the topic modeling results. Among the relevant papers, 11 meta-analysis studies [48,[70][71][72][73][74][75][76][77][78][79] were identified, and the correlation with keywords included in cluster 3 of this study was confirmed. Keywords related to major carcinomas were leukemia, brain tumor, and lymphoma, and for other cancer types, other cancer were designated as representative words.…”

Section: Principal Findingsmentioning

confidence: 58%

“…In particular, meta-analyses related to cardiac toxicity were predominant in 4 articles [48,[72][73][74]. Most of the studies conducted in the medical field were identified as the main characteristics of the studies that fall into cluster 3, and the characteristics of interdisciplinary research topic keywords were confirmed.…”

Section: Principal Findingsmentioning

confidence: 99%

Web-Based Research Trends on Child and Adolescent Cancer Survivors Over the Last 5 Years: Text Network Analysis and Topic Modeling Study

Kim¹,

Kang²,

Han³

et al. 2022

J Med Internet Res

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Background Being diagnosed with cancer during childhood or adolescence can disrupt important periods in an individual’s physical, psychosocial, and spiritual development and potentially reduce the quality of life (QOL) after treatment. Research is urgently required to improve the QOL for child and adolescent cancer survivors, and it is necessary to analyze the trends in prior research reported in international academic journals to identify knowledge structures. Objective This study aims to identify the main keywords based on network centrality, subgroups (clusters) of keyword networks by using a cohesion analysis method, and the main theme of child and adolescent cancer survivor–related research abstracts through topic modeling. This study also aims to label the subgroups by comparing the results of the cohesion and topic modeling. Methods A text network analysis method and topic modeling were used to explore the main trends in child and adolescent cancer survivor research by structuring a network of keyword (semantic morphemes) co-occurrence in the abstracts of articles published in 5 major web-based databases from 2016 to 2020. A total of 1677 child and adolescent cancer survivor–related studies were used for data analyses. Data selection, processing, and analyses were also conducted. Results The top 5 keywords in terms of degree and eigenvector centrality were risk, control interval, radiation, childhood cancer treatment, and diagnosis. Of the 1677 studies used for data analyses, cluster 1 included 780 (46.51%) documents under risk management, cluster 2 contained 557 (33.21%) articles under health-related QOL and supportive care, and cluster 3 consisted of 340 (20.27%) studies under cancer treatment and complications. Conclusions This study is significant in that it confirms the knowledge structure based on the main keywords and cross-disciplinary trends in child and adolescent cancer survivor research published in the last 5 years worldwide. The primary goal of child and adolescent cancer survivor research is to prevent and manage the various aspects of the problems encountered during the transition to a normal life and to improve the overall QOL. To this end, it is necessary to further revitalize the study of the multidisciplinary team approach for the promotion of age-specific health behaviors and the development of intervention strategies with increased feasibility for child and adolescent cancer survivors.

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Late-onset cardiomyopathy among survivors of childhood lymphoma treated with anthracyclines: a systematic review

Cited by 6 publications

References 65 publications

Use of Chronic Prescription Medications and Prevalence of Polypharmacy in Survivors of Childhood Cancer

Use of Chronic Prescription Medications and Prevalence of Polypharmacy in Survivors of Childhood Cancer

Effect of Dexrazoxane on Left Ventricular Systolic Function and Treatment Outcomes in Patients With Acute Myeloid Leukemia: A Report From the Children’s Oncology Group

Web-Based Research Trends on Child and Adolescent Cancer Survivors Over the Last 5 Years: Text Network Analysis and Topic Modeling Study

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