Cardiovascular risk factors in young adult survivors of childhood acute lymphoblastic leukemia

Kevin C. Oeffinger, George R. Buchanan, Debra A. Eshelman, Margo A. Denke, Thomas C. Andrews, John A. Germak, Gail E. Tomlinson, Laura E. Snell, Barbara M. Foster

Research output: Contribution to journalArticlepeer-review

136 Scopus citations

Abstract

Purpose To assess cardiovascular risk factors (CVRF) in young adult survivors of childhood acute lymphoblastic leukemia (ALL). Patients and Methods Twenty-six subjects (median age, 20.9 years; median interval since completion of therapy, 13.3 years) were evaluated. Ten participants had received cranial irradiation (CRT), whereas 16 had received only chemotherapy. Primary outcome measures included body mass index (BMI), blood pressure, fasting lipoprotein, glucose, and insulin levels. Secondary measures included insulin-like growth factor-1 (IGF-1) and IGF binding protein-3 levels, physical activity index, a 7-day dietary recall, tobacco product use, and measurement of the intima-media thickness (IMT) of the common carotid artery. Results Sixty-two percent (16/26) of participants had at least one CVRF potentially related to their cancer treatment (obesity, dyslipidemia, increased blood pressure, or insulin resistance), with 30% (7/26) having more than two CVRF. Thirty-one percent (8/26) of subjects were obese (BMI ≥30). Subjects who were treated with CRT (BMI, 30.4 ± 6.7) had an increased BMI (P = 0.039) in comparison with those who received only chemotherapy (BMI, 25.4 ± 5.1). Triglyceride and very low-density lipoprotein C levels were significantly higher in those treated with CRT (P = 0.027 and 0.022, respectively). The IGF-1 was inversely correlated with IMT (total group, -0.514, P = 0.009; females only, -0.729, P = 0.003). Conclusions Young adult survivors of childhood ALL, especially those treated with CRT, are at risk for obesity and dyslipidemia, insulin resistance, hypertension, and cardiovascular disease. Further investigation of these risks is warranted.

Original languageEnglish (US)
Pages (from-to)424-430
Number of pages7
JournalAmerican Journal of Pediatric Hematology/Oncology
Volume23
Issue number7
DOIs
StatePublished - Jan 1 2001

Keywords

  • Acute lymphoblastic leukemia
  • Cardiovascular disease
  • Long-term
  • Risk factors
  • Survivors

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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