Prediction of cardiovascular disease among hematopoietic cell transplantation survivors

Armenian, Saro H.; Yang, Dongyun; Teh, Jennifer Berano; Atencio, Liezl; Gonzales, Alicia; Wong, F. Lennie; Leisenring, Wendy; Forman, Stephen J.; Nakamura, Ryotaro; Chow, Eric J.

doi:10.1182/bloodadvances.2018019117

Cited by 66 publications

(66 citation statements)

References 57 publications

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“…There are many studies that have shown a higher prevalence of coronary artery disease and congestive heart failure in the cancer survivors [ 37 - 45 ]. The increased cardiovascular risk in the cancer survivors have been attributed secondary to a specific treatment for their cancers, such as hematopoietic stem cell transplantation [ 37 ], radiation or anthracycline therapy [ 38 - 41 ], use of trastuzumab, sorafenib and sunitinib, bevacizumab and other agents [ 42 - 44 ], and other cardiotoxicities [ 45 ]. Additionally, suboptimal control of multiple cardiovascular risk factors, such as hypertension, diabetes and hyperlipidemia, was also observed in the cancer survivors [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Comorbid Conditions Between Cancer Survivors and Age-Matched Patients Without Cancer

et al. 2018

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BackgroundCancer survivors suffer from many comorbid conditions even after the cure of their cancers beyond 5 years. We explored the differences in the association of comorbid conditions between the cancer survivors and patients without cancer.MethodsElectronic medical records of 280 adult cancer survivors and 280 age-matched patients without cancer in our suburban internal medicine office were reviewed.ResultsMean age of the cancer survivors was 72.5 ± 13.1 years, and the age of the patients without cancer was 72.5 ± 12.8 years. The number of male cancer survivors was significantly higher than the female cancer survivors (52.5% vs. 47.5%, P < 0.001). There were significantly more Caucasians and other races (majority Asians) in the cancer survivor group compared to the patients without cancer group (81.8% vs. 79.3% and 4.6% vs. 0.4%, respectively, P < 0.05); while there were significantly less African Americans and Hispanics in the cancer survivor group compared to the patients without cancer group (10.0% vs. 12.8% and 3.6% vs. 7.5%, respectively, P < 0.05). Hypertension (64.3%), hyperlipidemia (56.1%), osteoarthritis (34.3%), hypothyroidism (21.8%), diabetes mellitus (21.8%) and coronary artery disease (21.8%) were the most common comorbid conditions observed in the cancer survivors. Osteoarthritis was the only comorbid condition that was significantly less frequently associated with the cancer survivors compared to the patients without cancer (42.9%, P < 0.05). The frequencies of all other comorbid conditions were not significantly different between the two groups. The majority of our group of cancer survivors had one or more types of the top six cancers which include prostate cancer (30.7%), melanoma (13.9%), thyroid cancer (11.4%), colon cancer (11.1%), uterine cancer (11.1%) and urinary bladder cancer (11.1%); while only a few had cancer of the cervix (6.1%) or breast cancer (0.3%). Use of aspirin, statin, vitamin D, multivitamins, metformin and fish oil supplement in the cancer survivors was similar to the patients without cancer.ConclusionsHypertension, hyperlipidemia, osteoarthritis, hypothyroidism, diabetes mellitus and coronary artery disease are the most common associated comorbid conditions in the cancer survivors. Osteoarthritis is less frequently seen in the cancer survivors compared to the patients without cancer. The frequencies of other comorbid conditions are not significantly different between the two groups.

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Section: Discussionmentioning

confidence: 99%

Comparison of Comorbid Conditions Between Cancer Survivors and Age-Matched Patients Without Cancer

et al. 2018

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“…There have been several attempts at developing risk prediction models for identifying patients at highest risk for anthracycline-related cardiomyopathy. Clinical risk prediction models have yielded modest predictive power for identifying patients at risk for anthracycline-related cardiomyopathy ( 31 , 78 ), resulting in studies that combined genetic variants with clinical and demographic variables to improve the ability to disriminate anthracycline-exposed survivors by their risk of developing cardiomyopathy. Visscher et al ( 25 ) combined multiple variants from drug biotransformation genes together with clinical risk factors into a prediction model and classified patients into 3 risk groups.…”

Section: Prediction Of Anthracycline-related Cardiomyopathymentioning

confidence: 99%

Genetics of Anthracycline Cardiomyopathy in Cancer Survivors

Bhatia

2020

JACC: CardioOncology

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Anthracyclines are an integral part of chemotherapy regimens used to treat a variety of childhood-onset and adult-onset cancers. However, the development of cardiac dysfunction and heart failure often compromises the clinical utility of anthracyclines. The risk of cardiac dysfunction increases with anthracycline dose. This anthracycline-cardiac dysfunction association is modified by several demographic and clinical factors, such as age at anthracycline exposure (<4 years and ≥65 years); female sex; chest radiation; presence of cardiovascular risk factors (diabetes, hypertension); and concurrent use of cyclophosphamide, paclitaxel, and trastuzumab. However, the clinical variables alone yield modest predictive power in detecting cardiac dysfunction. Recently, attention has focused on the molecular basis of anthracycline-related cardiac dysfunction, providing an initial understanding of the mechanism of anthracycline-related cardiomyopathy. This review describes the current state of knowledge with respect to the pathogenesis of anthracycline-related cardiomyopathy and identifies the critical next steps to mitigate this problem.

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“…Notably, CVD is also a significant morbidity in HSCT patients ( Armenian et al., 2017 ). As in CHIP, HSCT patients exhibit heart failure and coronary artery disease; however, the mechanisms underlying this presentation are not known ( Armenian et al., 2018 ). In a model of Tet2 deficiency in atherosclerosis-prone low-density lipoprotein receptor -deficient mice, macrophages secreting IL-1β exacerbate atherosclerosis ( Fuster et al., 2017 ).…”

Section: Main Textmentioning

confidence: 99%

Clonal Hematopoiesis of Indeterminate Potential as a Novel Risk Factor for Donor-Derived Leukemia

Burns

Kapur

2020

Stem Cell Reports

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Hematopoietic stem cell transplantation (HSCT) is a critical treatment modality for many hematological and non-hematological diseases that is being extended to treat older individuals. However, recent studies show that clonal hematopoiesis of indeterminate potential (CHIP), a common, asymptomatic condition characterized by the expansion of age-acquired somatic mutations in blood cell lineages, may be a risk factor for the development of donor-derived leukemia (DDL), unexplained cytopenias, and chronic graft-versus-host disease. CHIP may contribute to the pathogenesis of these significant transplant complications via various cell-autonomous and non-cell-autonomous mechanisms, and the clinical presentation of DDL may be broader than anticipated. A more comprehensive understanding of the contributions of CHIP to DDL may have important implications for the screening of donors and will improve the safety of HSCT. The objective of this review is to discuss studies linking DDL and CHIP and to explore potential mechanisms by which CHIP may contribute to DDL.

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Prediction of cardiovascular disease among hematopoietic cell transplantation survivors

Cited by 66 publications

References 57 publications

Comparison of Comorbid Conditions Between Cancer Survivors and Age-Matched Patients Without Cancer

Comparison of Comorbid Conditions Between Cancer Survivors and Age-Matched Patients Without Cancer

Genetics of Anthracycline Cardiomyopathy in Cancer Survivors

Clonal Hematopoiesis of Indeterminate Potential as a Novel Risk Factor for Donor-Derived Leukemia

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