Pilot study of vascular health in survivors of Hodgkin lymphoma

Daniel A. Mulrooney, Kirsten K. Ness, Anna Solovey, Robert P Hebbel, Jim Neaton, Bruce A Peterson, Chung K Lee, Aaron S Kelly, Joseph P Neglia

Research output: Contribution to journalArticle

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Abstract

Background: Vascular-related toxicities have been reported among survivors of Hodgkin lymphoma (HL), but their genesis is not well understood. Procedure: Fasting blood samples from 25 previously irradiated HL survivors were analyzed for biomarkers that can reveal underlying inflammation and/or endothelial cell activation: high-sensitivity C-reactive protein (hsCRP), triglycerides, total cholesterol, high-density lipoprotein (HDL), apolipoprotein ß, lipoprotein (a), fibrinogen, circulating endothelial cells (CECs), and vascular cell adhesion molecule-1 (VCAM-1) expression. Values were compared to subjects in the Coronary Artery Risk Development in Young Adults (CARDIA) study. CECs and VCAM-1 were compared to healthy controls. Results: Survivors (76% male), median age 17.6 years (5-33) at diagnosis, 33.0 years (19-55) at follow-up, included stages IA (n=6), IIA (n=10), IIB (n=2), IIIA (n=4), and IVA (n=3) patients. Twenty-four received at least chest radiation therapy (RT) (median dose 3,150 cGy; range: 175-4,650 cGy), one received neck only; 14 (56%) had a history of anthracycline exposure (median dose: 124mg/m 2 range: 63-200mg/m2). Compared to CARDIA subjects, mean hsCRP (3.0mg/L±2.0 vs. 1.6±1.9), total cholesterol (194.1mg/dl±33.2 vs. 179.4±32.9), lipoprotein (a) (34.2mg/dl±17.5 vs. 13.8±17.5), and fibrinogen (342.0mg/dl±49.1 vs. 252.6±48.4) were significantly elevated. CECs (2.3 cells/ml±1.5 vs. 0.34±1.4) were significantly elevated compared to controls. No difference in VCAM-1 expression (51.1%±36.8 vs. 42.3±35.6) was detected. Conclusion: HL survivors exposed to RT have evidence of vascular inflammation, dyslipidemia, and injury suggestive of early atherogenesis.

Original languageEnglish (US)
Pages (from-to)285-289
Number of pages5
JournalPediatric Blood and Cancer
Volume59
Issue number2
DOIs
StatePublished - Aug 1 2012

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Hodgkin Disease
Blood Vessels
Survivors
Vascular Cell Adhesion Molecule-1
Endothelial Cells
Lipoprotein(a)
Health
C-Reactive Protein
Fibrinogen
Young Adult
Coronary Vessels
Radiotherapy
Inflammation
Apolipoproteins
Anthracyclines
Dyslipidemias
HDL Cholesterol
Fasting
Atherosclerosis
Triglycerides

Keywords

  • Hodgkin lymphoma
  • Survivorship
  • Vascular late effects

Cite this

Pilot study of vascular health in survivors of Hodgkin lymphoma. / Mulrooney, Daniel A.; Ness, Kirsten K.; Solovey, Anna; Hebbel, Robert P; Neaton, Jim; Peterson, Bruce A; Lee, Chung K; Kelly, Aaron S; Neglia, Joseph P.

In: Pediatric Blood and Cancer, Vol. 59, No. 2, 01.08.2012, p. 285-289.

Research output: Contribution to journalArticle

Mulrooney, Daniel A. ; Ness, Kirsten K. ; Solovey, Anna ; Hebbel, Robert P ; Neaton, Jim ; Peterson, Bruce A ; Lee, Chung K ; Kelly, Aaron S ; Neglia, Joseph P. / Pilot study of vascular health in survivors of Hodgkin lymphoma. In: Pediatric Blood and Cancer. 2012 ; Vol. 59, No. 2. pp. 285-289.
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abstract = "Background: Vascular-related toxicities have been reported among survivors of Hodgkin lymphoma (HL), but their genesis is not well understood. Procedure: Fasting blood samples from 25 previously irradiated HL survivors were analyzed for biomarkers that can reveal underlying inflammation and/or endothelial cell activation: high-sensitivity C-reactive protein (hsCRP), triglycerides, total cholesterol, high-density lipoprotein (HDL), apolipoprotein {\ss}, lipoprotein (a), fibrinogen, circulating endothelial cells (CECs), and vascular cell adhesion molecule-1 (VCAM-1) expression. Values were compared to subjects in the Coronary Artery Risk Development in Young Adults (CARDIA) study. CECs and VCAM-1 were compared to healthy controls. Results: Survivors (76{\%} male), median age 17.6 years (5-33) at diagnosis, 33.0 years (19-55) at follow-up, included stages IA (n=6), IIA (n=10), IIB (n=2), IIIA (n=4), and IVA (n=3) patients. Twenty-four received at least chest radiation therapy (RT) (median dose 3,150 cGy; range: 175-4,650 cGy), one received neck only; 14 (56{\%}) had a history of anthracycline exposure (median dose: 124mg/m 2 range: 63-200mg/m2). Compared to CARDIA subjects, mean hsCRP (3.0mg/L±2.0 vs. 1.6±1.9), total cholesterol (194.1mg/dl±33.2 vs. 179.4±32.9), lipoprotein (a) (34.2mg/dl±17.5 vs. 13.8±17.5), and fibrinogen (342.0mg/dl±49.1 vs. 252.6±48.4) were significantly elevated. CECs (2.3 cells/ml±1.5 vs. 0.34±1.4) were significantly elevated compared to controls. No difference in VCAM-1 expression (51.1{\%}±36.8 vs. 42.3±35.6) was detected. Conclusion: HL survivors exposed to RT have evidence of vascular inflammation, dyslipidemia, and injury suggestive of early atherogenesis.",
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AU - Neaton, Jim

AU - Peterson, Bruce A

AU - Lee, Chung K

AU - Kelly, Aaron S

AU - Neglia, Joseph P

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N2 - Background: Vascular-related toxicities have been reported among survivors of Hodgkin lymphoma (HL), but their genesis is not well understood. Procedure: Fasting blood samples from 25 previously irradiated HL survivors were analyzed for biomarkers that can reveal underlying inflammation and/or endothelial cell activation: high-sensitivity C-reactive protein (hsCRP), triglycerides, total cholesterol, high-density lipoprotein (HDL), apolipoprotein ß, lipoprotein (a), fibrinogen, circulating endothelial cells (CECs), and vascular cell adhesion molecule-1 (VCAM-1) expression. Values were compared to subjects in the Coronary Artery Risk Development in Young Adults (CARDIA) study. CECs and VCAM-1 were compared to healthy controls. Results: Survivors (76% male), median age 17.6 years (5-33) at diagnosis, 33.0 years (19-55) at follow-up, included stages IA (n=6), IIA (n=10), IIB (n=2), IIIA (n=4), and IVA (n=3) patients. Twenty-four received at least chest radiation therapy (RT) (median dose 3,150 cGy; range: 175-4,650 cGy), one received neck only; 14 (56%) had a history of anthracycline exposure (median dose: 124mg/m 2 range: 63-200mg/m2). Compared to CARDIA subjects, mean hsCRP (3.0mg/L±2.0 vs. 1.6±1.9), total cholesterol (194.1mg/dl±33.2 vs. 179.4±32.9), lipoprotein (a) (34.2mg/dl±17.5 vs. 13.8±17.5), and fibrinogen (342.0mg/dl±49.1 vs. 252.6±48.4) were significantly elevated. CECs (2.3 cells/ml±1.5 vs. 0.34±1.4) were significantly elevated compared to controls. No difference in VCAM-1 expression (51.1%±36.8 vs. 42.3±35.6) was detected. Conclusion: HL survivors exposed to RT have evidence of vascular inflammation, dyslipidemia, and injury suggestive of early atherogenesis.

AB - Background: Vascular-related toxicities have been reported among survivors of Hodgkin lymphoma (HL), but their genesis is not well understood. Procedure: Fasting blood samples from 25 previously irradiated HL survivors were analyzed for biomarkers that can reveal underlying inflammation and/or endothelial cell activation: high-sensitivity C-reactive protein (hsCRP), triglycerides, total cholesterol, high-density lipoprotein (HDL), apolipoprotein ß, lipoprotein (a), fibrinogen, circulating endothelial cells (CECs), and vascular cell adhesion molecule-1 (VCAM-1) expression. Values were compared to subjects in the Coronary Artery Risk Development in Young Adults (CARDIA) study. CECs and VCAM-1 were compared to healthy controls. Results: Survivors (76% male), median age 17.6 years (5-33) at diagnosis, 33.0 years (19-55) at follow-up, included stages IA (n=6), IIA (n=10), IIB (n=2), IIIA (n=4), and IVA (n=3) patients. Twenty-four received at least chest radiation therapy (RT) (median dose 3,150 cGy; range: 175-4,650 cGy), one received neck only; 14 (56%) had a history of anthracycline exposure (median dose: 124mg/m 2 range: 63-200mg/m2). Compared to CARDIA subjects, mean hsCRP (3.0mg/L±2.0 vs. 1.6±1.9), total cholesterol (194.1mg/dl±33.2 vs. 179.4±32.9), lipoprotein (a) (34.2mg/dl±17.5 vs. 13.8±17.5), and fibrinogen (342.0mg/dl±49.1 vs. 252.6±48.4) were significantly elevated. CECs (2.3 cells/ml±1.5 vs. 0.34±1.4) were significantly elevated compared to controls. No difference in VCAM-1 expression (51.1%±36.8 vs. 42.3±35.6) was detected. Conclusion: HL survivors exposed to RT have evidence of vascular inflammation, dyslipidemia, and injury suggestive of early atherogenesis.

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