Journal article
Increased risk of cardiac ischaemia in a pan-European cohort of 36 205 childhood cancer survivors: a PanCareSurFup study.
- Feijen EAM Pediatric Oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands e.a.m.feijen@prinsesmaximacentrum.nl.
- van Dalen EC Pediatric Oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands.
- van der Pal HJH Pediatric Oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands.
- Reulen RC University of Birmingham, Birmingham, UK.
- Winter DL University of Birmingham, Birmingham, UK.
- Keuhni CE University of Bern, Bern, Switzerland.
- Morsellino V Giannina Gaslini Children's Hospital, Genova, Italy.
- Alessi D Childhood Cancer Registry of Piedmont, Torino, Italy.
- Allodji RS Gustave Roussy, Villejuif, Île-de-France, France.
- Byrne J Boyne Institute, Drogheda, Ireland.
- Bardi E Kepler University Clinic, Linz, Austria.
- Jakab Z Markusovszky University Teaching Hospital, Szombathely, Vas, Hungary.
- Grabow D University Medical Center Mainz, Mainz, Germany.
- Garwicz S Skåne University Hospital Lund, Lund, Sweden.
- Haddy N INSERM, Paris, France.
- Jankovic M Hospital San Gerardo, Monza, Italy.
- Kaatsch P University Medical Center Mainz, Mainz, Germany.
- Levitt GA Great Ormond Street Hospital for Children, London, UK.
- Ronckers CM Pediatric Oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands.
- Schindera C University of Bern, Bern, Switzerland.
- Skinner R Newcastle University, Newcastle upon Tyne, UK.
- Zalatel L Institute of Oncology Ljubljana, Ljubljana, Slovenia.
- Hjorth L Skåne University Hospital Lund, Lund, Sweden.
- Tissing WJE Pediatric Oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands.
- De Vathaire F Gustave Roussy, Villejuif, Île-de-France, France.
- Hawkins MM University of Birmingham, Birmingham, UK.
- Kremer LCM Pediatric Oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands.
- 2020-08-23
Published in:
- Heart (British Cardiac Society). - 2020
English
OBJECTIVE
In this report, we determine the cumulative incidence of symptomatic cardiac ischaemia and its risk factors among European 5-year childhood cancer survivors (CCS) participating in the PanCareSurFup study.
METHODS
Eight data providers (France, Hungary, Italy (two cohorts), the Netherlands, Slovenia, Switzerland and the UK) participating in PanCareSurFup ascertained and validated symptomatic cardiac events among their 36 205 eligible CCS. Data on symptomatic cardiac ischaemia were graded according to the Criteria for Adverse Events V.3.0 (grade 3-5). We calculated cumulative incidences, both overall and for different subgroups based on treatment and malignancy, and used multivariable Cox regression to analyse risk factors.
RESULTS
Overall, 302 out of the 36 205 CCS developed symptomatic cardiac ischaemia during follow-up (median follow-up time after primary cancer diagnosis: 23.0 years). The cumulative incidence by age 60 was 5.4% (95% CI 4.6% to 6.2%). Men (7.1% (95% CI 5.8 to 8.4)) had higher rates than women (3.4% (95% CI 2.4 to 4.4)) (p<0.0001). Of importance is that a significant number of patients (41/302) were affected as teens or young adults (14-30 years). Treatment with radiotherapy/chemotherapy conferred twofold risk (95% CI 1.5 to 3.0) and cases in these patients appeared earlier than in CCS without treatment/surgery only (15% vs 3% prior to age 30 years, respectively (p=0.04)).
CONCLUSIONS
In this very large European childhood cancer cohort, we found that by age 60 years, 1 in 18 CCS will develop a severe, life-threatening or fatal cardiac ischaemia, especially in lymphoma survivors and CCS treated with radiotherapy and chemotherapy increases the risk significantly.
In this report, we determine the cumulative incidence of symptomatic cardiac ischaemia and its risk factors among European 5-year childhood cancer survivors (CCS) participating in the PanCareSurFup study.
METHODS
Eight data providers (France, Hungary, Italy (two cohorts), the Netherlands, Slovenia, Switzerland and the UK) participating in PanCareSurFup ascertained and validated symptomatic cardiac events among their 36 205 eligible CCS. Data on symptomatic cardiac ischaemia were graded according to the Criteria for Adverse Events V.3.0 (grade 3-5). We calculated cumulative incidences, both overall and for different subgroups based on treatment and malignancy, and used multivariable Cox regression to analyse risk factors.
RESULTS
Overall, 302 out of the 36 205 CCS developed symptomatic cardiac ischaemia during follow-up (median follow-up time after primary cancer diagnosis: 23.0 years). The cumulative incidence by age 60 was 5.4% (95% CI 4.6% to 6.2%). Men (7.1% (95% CI 5.8 to 8.4)) had higher rates than women (3.4% (95% CI 2.4 to 4.4)) (p<0.0001). Of importance is that a significant number of patients (41/302) were affected as teens or young adults (14-30 years). Treatment with radiotherapy/chemotherapy conferred twofold risk (95% CI 1.5 to 3.0) and cases in these patients appeared earlier than in CCS without treatment/surgery only (15% vs 3% prior to age 30 years, respectively (p=0.04)).
CONCLUSIONS
In this very large European childhood cancer cohort, we found that by age 60 years, 1 in 18 CCS will develop a severe, life-threatening or fatal cardiac ischaemia, especially in lymphoma survivors and CCS treated with radiotherapy and chemotherapy increases the risk significantly.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1136/heartjnl-2020-316655
- PMID 32826285
- Persistent URL
- https://sonar.ch/global/documents/46891
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