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  • De Baat, Esmée C.Princess Maxima Center for Pediatric Oncology/Hematology (author)

Risk Factors for Heart Failure among Pan-European Childhood Cancer Survivors : A PanCareSurFup and ProCardio Cohort and Nested Case-Control Study

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • 2023
  • 11 s.

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  • LIBRIS-ID:oai:lup.lub.lu.se:72043cc0-b08e-493d-bbaa-b3aa62df471f
  • https://lup.lub.lu.se/record/72043cc0-b08e-493d-bbaa-b3aa62df471fURI
  • https://doi.org/10.1200/JCO.21.02944DOI

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  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • PURPOSE Heart failure (HF) is a potentially life-threatening complication of treatment for childhood cancer. We evaluated the risk and risk factors for HF in a large European study of long-term survivors. Little is known of the effects of low doses of treatment, which is needed to improve current treatment protocols and surveillance guidelines.METHODSThis study includes the PanCareSurFup and ProCardio cohort of ≥ 5-year childhood cancer survivors diagnosed between 1940 and 2009 in seven European countries (N = 42,361). We calculated the cumulative incidence of HF and conducted a nested case-control study to evaluate detailed treatment-related risk factors.RESULTSThe cumulative incidence of HF was 2% (95% CI, 1.7 to 2.2) by age 50 years. The case-control study (n = 1,000) showed that survivors who received a mean heart radiation therapy (RT) dose of 5 to < 15 Gy have an increased risk of HF (odds ratio, 5.5; 95% CI, 2.5 to 12.3), when compared with no heart RT. The risk associated with doses 5 to < 15 Gy increased with exposure of a larger heart volume. In addition, the HF risk increased in a linear fashion with higher mean heart RT doses. Regarding total cumulative anthracycline dose, survivors who received ≥ 100 mg/m2 had a substantially increased risk of HF and survivors treated with a lower dose showed no significantly increased risk of HF. The dose-response relationship appeared quadratic with higher anthracycline doses.CONCLUSIONSurvivors who received a mean heart RT dose of ≥ 5 Gy have an increased risk of HF. The risk associated with RT increases with larger volumes exposed. Survivors treated with < 100 mg/m2 total cumulative anthracycline dose have no significantly increased risk of HF. These new findings might have consequences for new treatment protocols for children with cancer and for cardiomyopathy surveillance guidelines.

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  • Feijen, Elizabeth A.M.Princess Maxima Center for Pediatric Oncology/Hematology (author)
  • Reulen, Raoul C.University of Birmingham (author)
  • Allodji, Rodrigue S.Institut Gustave Roussy,University of Paris-Saclay (author)
  • Bagnasco, FrancescaGaslini Children's Hospital (author)
  • Bardi, EditSt. Anna Children's Hospital,Kepler University Hospital Linz (author)
  • Belle, Fabiën N.University of Lausanne,University of Bern (author)
  • Byrne, JulianneBoyne Research Institute (author)
  • Van Dalen, Elvira C.Princess Maxima Center for Pediatric Oncology/Hematology (author)
  • Debiche, GhaziInstitut Gustave Roussy,University of Paris-Saclay (author)
  • Diallo, IbrahimaUniversity of Paris-Saclay,Institut Gustave Roussy (author)
  • Grabow, DesireeUniversitätsmedizin Mainz (author)
  • Hjorth, LarsLund University,Lunds universitet,Sena effekter efter barncancerbehandling,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Late effects after childhood cancer treatment,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital(Swepub:lu)pedi-lhj (author)
  • Jankovic, MomciloUniversity of Milano-Bicocca (author)
  • Kuehni, Claudia E.University of Bern,Bern University Hospital (author)
  • Levitt, GillGreat Ormond Street Hospital (author)
  • Llanas, DamienInstitut Gustave Roussy,University of Paris-Saclay (author)
  • Loonen, JacquelineRadboud University Medical Center (author)
  • Zaletel, Lorna Z.Institute of Oncology, Ljubljana (author)
  • Maule, Milena M.University of Turin (author)
  • Miligi, LuciaInstitute for Cancer Research, Prevention and Clinical Network (ISPRO) (author)
  • Van Der Pal, Helena J.H.Princess Maxima Center for Pediatric Oncology/Hematology (author)
  • Ronckers, Cécile M.Princess Maxima Center for Pediatric Oncology/Hematology (author)
  • Sacerdote, CarlottaUniversity of Turin (author)
  • Skinner, RoderickRoyal Victoria Infirmary,University of Newcastle upon Tyne (author)
  • Jakab, ZsuzsannaSemmelweis University (author)
  • Veres, CristinaUniversity of Paris-Saclay,Institut Gustave Roussy (author)
  • Haddy, NadiaInstitut Gustave Roussy,University of Paris-Saclay (author)
  • Winter, David L.University of Birmingham (author)
  • De Vathaire, FlorentUniversity of Paris-Saclay,Institut Gustave Roussy (author)
  • Hawkins, Michael M.University of Birmingham (author)
  • Kremer, Leontien C.M.Academic Medical Center of University of Amsterdam (AMC),Princess Maxima Center for Pediatric Oncology/Hematology (author)
  • Princess Maxima Center for Pediatric Oncology/HematologyUniversity of Birmingham (creator_code:org_t)

Related titles

  • In:Journal of Clinical Oncology41:1, s. 96-1060732-183X

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