Pulmonary function abnormalities in childhood cancer survivors treated with bleomycin

De, Aliva; Guryev, Igor V.; LaRiviere, Alejandro; Kato, Roberta M.; Wee, Choo Phei; Mascarenhas, Leo; Keens, Thomas G.; Venkatramani, Rajkumar

doi:10.1002/pbc.25098

Cited by 33 publications

(40 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Moreover, bleomycin is known to induce a wide variety of respiratory and pulmonary dysfunctions, including pulmonary fibrosis. 32 Systemic toxicity is low in ECT because the bleomycin doses administered systemically are relatively low (the very high intratumoral concentrations of cytostatic agents are a result of electroporation). Nevertheless, 1 patient in our study died from a worsening of underlying pulmonary fibrosis.…”

Section: Discussionmentioning

confidence: 99%

Electrochemotherapy in the Treatment of Melanoma Skin Metastases: A Report on 31 Cases

Mir-Bonafé

Vilalta

Alarcón

et al. 2015

Actas Dermo-Sifiliográficas (English Edition)

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Electrochemotherapy in the Treatment of Melanoma Skin Metastases: A Report on 31 Cases

Mir-Bonafé

Vilalta

Alarcón

et al. 2015

Actas Dermo-Sifiliográficas (English Edition)

View full text Add to dashboard Cite

show abstract

“…34 Among AYA survivors of childhood cancer who had received bleomycin, De et al found at least one pulmonary function abnormality, including obstructive lung disease, and impairments in lung capacity, expiratory volume, expiratory flow, and residual volume, in 52.5% of survivors after a median follow-up time of 3.9 years after diagnosis. 35 Similarly, after a median of 18 years of follow-up among childhood cancer survivors treated with bleomycin, Mulder et al found pulmonary function impairments in 44% of survivors. 36 37 Finally, using a comprehensive systematic clinical assessment, Hudson et al found that the prevalence of adverse outcomes by organ system among adult survivors of childhood cancer was highest for the pulmonary system, with abnormal pulmonary function found in 65.2% of survivors after a median time from diagnosis of 25 years.…”

Section: Pulmonary Limitationsmentioning

confidence: 97%

A Review of Cardiorespiratory Fitness in Adolescent and Young Adult Survivors of Childhood Cancer: Factors that Affect its Decline and Opportunities for Intervention

Berkman

Lakoski

2016

Journal of Adolescent and Young Adult Oncology

View full text Add to dashboard Cite

Childhood cancer incidence and survivorship rates are increasing, leading to a growing population of survivors that are at risk for competing causes of death, most notably cardiovascular disease (CVD). Cardiorespiratory fitness (CRF), a key modifiable CVD risk factor, is lower than expected among childhood survivors 5-20 years post-diagnosis. This review discusses the studies that demonstrate lower CRF in survivors of childhood cancer and the potential mechanisms and factors contributing to lower CRF in this population. Both exercise interventions and strategies to improve CRF are considered. The review advocates for more robust clinical research and exercise interventions to improve CRF with the goal of reducing comorbidities and competing CVD risk among childhood cancer survivors into adolescence and young adulthood.

show abstract

“…Treatment for HL typically includes a vinca-alkaloid agent, which can affect peripheral nervous system function (10). A prospective study should also include measures of cardiac perfusion, myocardial contractility, and pulmonary function to determine if autonomic dysfunction is an impairment that can be distinguished from ischemia, myopathy, valve disease, and pulmonary abnormalities and so that contributions of these known problems among HL survivors to ETT can be accounted for (11)(12)(13)(14).…”

mentioning

confidence: 99%

Screening for Cardiac Autonomic Dysfunction Among Hodgkin Lymphoma Survivors Treated With Thoracic Radiation∗

Ness

Armstrong

2015

Journal of the American College of Cardiology

View full text Add to dashboard Cite

T he report from Groarke et al. (1) in this issue of the Journal describes elevated resting heart rate and slowed post-exercise heart rate recovery (HRR) among 263 survivors of adultonset Hodgkin lymphoma (HL) treated with thoracic radiation who were referred for exercise treadmill testing (ETT) when compared with patients (n ¼ 526) also referred for ETT but who did not have HL or thoracic radiation exposure. In models adjusted for other known cardiovascular disease risk factors, these signs of potential cardiac autonomic dysfunction were associated with radiation dose and with inclusion of the neck in the radiation field. Whereas total aerobic capacity on ETT did not differ between HL survivors and control subjects, other ETT abnormalities suggestive of autonomic dysfunction, including reduced heart rate reserve, a blunted systolic blood pressure response, and an abnormal reserve pulse pressure, were detected more frequently in HL survivors. An abnormal HHR among survivors, defined as drop of 12 beats/min or 18 beats/min in the first minute of active or passive recovery after ETT, was associated with an age-adjusted increased risk for all-cause mortality, including cancer-related deaths, of 4.60 (95% confidence interval: 1.62 to 13.02) over a median of 3.0 years. Importantly, the association between abnormal HRR and mortality persisted in models when persons with ischemic heart disease were removed from the analysis and when ejection fraction, typically used to characterize heart failure in this population, was taken into account. An analysis of the association between HHR and cardiac mortality would strengthen the argument for the importance of these measures.Because the study population was a convenience sample that included only HL survivors referred for rather than systematically evaluated with ETT, there is the potential for a selection bias. However, these data support findings from a previous report among survivors of childhood-onset HL treated with thoracic radiation in which autonomic dysfunction was suggested by reduced heart rate variability in 57%, an elevated resting heart rate in 31%, and abnormal hemodynamic response to exercise in 27% (2). The results of the Groarke et al. (1) report are compelling because they indicate the presence of radiationassociated cardiac autonomic dysfunction and suggest an independent contribution of cardiac autonomic dysfunction to mortality among HL survivors exposed to thoracic radiation. The inability of the cardiovascular system to respond or recover from exertion may help explain symptoms commonly described among survivors of HL not otherwise attributable to clinically detectable cardiac disease.These symptoms include persistent fatigue (3-5), physical performance limitations (6), and difficulty participating in regular physical activity (7). Remediation of autonomic dysfunction, along with management of cardiac risk factors known to substantially escalate risk for adverse cardiac outcomes in this population (8), may be a potential target to help alleviate sympto...

show abstract

Pulmonary function abnormalities in childhood cancer survivors treated with bleomycin

Abstract: More than half the patients who received bleomycin had subclinical pulmonary dysfunction as evidenced by abnormalities in pulmonary function tests, although the incidence of clinical symptoms was low.

Cited by 33 publications

References 48 publications

Electrochemotherapy in the Treatment of Melanoma Skin Metastases: A Report on 31 Cases

Electrochemotherapy in the Treatment of Melanoma Skin Metastases: A Report on 31 Cases

A Review of Cardiorespiratory Fitness in Adolescent and Young Adult Survivors of Childhood Cancer: Factors that Affect its Decline and Opportunities for Intervention

Screening for Cardiac Autonomic Dysfunction Among Hodgkin Lymphoma Survivors Treated With Thoracic Radiation∗

Contact Info

Product

Resources

About