Cardiovascular disease in adult survivors of childhood cancer

Steven E Lipshultz, Vivian I. Franco, Tracie L Miller, Steven D. Colan, Stephen E. Sallan

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Treatment advances have increased survival in children with cancer, but subclinical, progressive, irreversible, and sometimes fatal treatment-related cardiovascular effects may appear years later. Cardio-oncologists have identified promising preventive and treatment strategies. Dexrazoxane provides long-term cardioprotection from doxorubicin-associated cardiotoxicity without compromising the efficacy of anticancer treatment. Continuous infusion of doxorubicin is as effective as bolus administration in leukemia treatment, but no evidence has indicated that it provides long-term cardioprotection; continuous infusions should be eliminated from pediatric cancer treatment. Angiotensin-converting enzyme inhibitors can delay the progression of subclinical and clinical cardiotoxicity. All survivors, regardless of whether they were treated with anthracyclines or radiation, should be monitored for systemic inflammation and the risk of premature cardiovascular disease. Echocardiographic screening must be supplemented with screening for biomarkers of cardiotoxicity and perhaps by identification of genetic susceptibilities to cardiovascular diseases; optimal strategies need to be identified. The health burden related to cancer treatment will increase as this population expands and ages.

Original languageEnglish
Pages (from-to)161-176
Number of pages16
JournalAnnual Review of Medicine
Volume66
DOIs
StatePublished - Jan 1 2015

Fingerprint

Oncology
Doxorubicin
Screening
Cardiovascular Diseases
Dexrazoxane
Pediatrics
Anthracyclines
Biomarkers
Angiotensin-Converting Enzyme Inhibitors
Neoplasms
Health
Radiation
Therapeutics
Second Primary Neoplasms
Genetic Predisposition to Disease
Leukemia
Inflammation
Population
Cardiotoxicity

Keywords

  • etiology
  • prevention
  • screening
  • treatment

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Lipshultz, S. E., Franco, V. I., Miller, T. L., Colan, S. D., & Sallan, S. E. (2015). Cardiovascular disease in adult survivors of childhood cancer. Annual Review of Medicine, 66, 161-176. https://doi.org/10.1146/annurev-med-070213-054849

Cardiovascular disease in adult survivors of childhood cancer. / Lipshultz, Steven E; Franco, Vivian I.; Miller, Tracie L; Colan, Steven D.; Sallan, Stephen E.

In: Annual Review of Medicine, Vol. 66, 01.01.2015, p. 161-176.

Research output: Contribution to journalArticle

Lipshultz, SE, Franco, VI, Miller, TL, Colan, SD & Sallan, SE 2015, 'Cardiovascular disease in adult survivors of childhood cancer', Annual Review of Medicine, vol. 66, pp. 161-176. https://doi.org/10.1146/annurev-med-070213-054849
Lipshultz, Steven E ; Franco, Vivian I. ; Miller, Tracie L ; Colan, Steven D. ; Sallan, Stephen E. / Cardiovascular disease in adult survivors of childhood cancer. In: Annual Review of Medicine. 2015 ; Vol. 66. pp. 161-176.
@article{2962373c09b54a0dac83e60cac8dce24,
title = "Cardiovascular disease in adult survivors of childhood cancer",
abstract = "Treatment advances have increased survival in children with cancer, but subclinical, progressive, irreversible, and sometimes fatal treatment-related cardiovascular effects may appear years later. Cardio-oncologists have identified promising preventive and treatment strategies. Dexrazoxane provides long-term cardioprotection from doxorubicin-associated cardiotoxicity without compromising the efficacy of anticancer treatment. Continuous infusion of doxorubicin is as effective as bolus administration in leukemia treatment, but no evidence has indicated that it provides long-term cardioprotection; continuous infusions should be eliminated from pediatric cancer treatment. Angiotensin-converting enzyme inhibitors can delay the progression of subclinical and clinical cardiotoxicity. All survivors, regardless of whether they were treated with anthracyclines or radiation, should be monitored for systemic inflammation and the risk of premature cardiovascular disease. Echocardiographic screening must be supplemented with screening for biomarkers of cardiotoxicity and perhaps by identification of genetic susceptibilities to cardiovascular diseases; optimal strategies need to be identified. The health burden related to cancer treatment will increase as this population expands and ages.",
keywords = "etiology, prevention, screening, treatment",
author = "Lipshultz, {Steven E} and Franco, {Vivian I.} and Miller, {Tracie L} and Colan, {Steven D.} and Sallan, {Stephen E.}",
year = "2015",
month = "1",
day = "1",
doi = "10.1146/annurev-med-070213-054849",
language = "English",
volume = "66",
pages = "161--176",
journal = "Annual Review of Medicine",
issn = "0066-4219",
publisher = "Annual Reviews Inc.",

}

TY - JOUR

T1 - Cardiovascular disease in adult survivors of childhood cancer

AU - Lipshultz, Steven E

AU - Franco, Vivian I.

AU - Miller, Tracie L

AU - Colan, Steven D.

AU - Sallan, Stephen E.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Treatment advances have increased survival in children with cancer, but subclinical, progressive, irreversible, and sometimes fatal treatment-related cardiovascular effects may appear years later. Cardio-oncologists have identified promising preventive and treatment strategies. Dexrazoxane provides long-term cardioprotection from doxorubicin-associated cardiotoxicity without compromising the efficacy of anticancer treatment. Continuous infusion of doxorubicin is as effective as bolus administration in leukemia treatment, but no evidence has indicated that it provides long-term cardioprotection; continuous infusions should be eliminated from pediatric cancer treatment. Angiotensin-converting enzyme inhibitors can delay the progression of subclinical and clinical cardiotoxicity. All survivors, regardless of whether they were treated with anthracyclines or radiation, should be monitored for systemic inflammation and the risk of premature cardiovascular disease. Echocardiographic screening must be supplemented with screening for biomarkers of cardiotoxicity and perhaps by identification of genetic susceptibilities to cardiovascular diseases; optimal strategies need to be identified. The health burden related to cancer treatment will increase as this population expands and ages.

AB - Treatment advances have increased survival in children with cancer, but subclinical, progressive, irreversible, and sometimes fatal treatment-related cardiovascular effects may appear years later. Cardio-oncologists have identified promising preventive and treatment strategies. Dexrazoxane provides long-term cardioprotection from doxorubicin-associated cardiotoxicity without compromising the efficacy of anticancer treatment. Continuous infusion of doxorubicin is as effective as bolus administration in leukemia treatment, but no evidence has indicated that it provides long-term cardioprotection; continuous infusions should be eliminated from pediatric cancer treatment. Angiotensin-converting enzyme inhibitors can delay the progression of subclinical and clinical cardiotoxicity. All survivors, regardless of whether they were treated with anthracyclines or radiation, should be monitored for systemic inflammation and the risk of premature cardiovascular disease. Echocardiographic screening must be supplemented with screening for biomarkers of cardiotoxicity and perhaps by identification of genetic susceptibilities to cardiovascular diseases; optimal strategies need to be identified. The health burden related to cancer treatment will increase as this population expands and ages.

KW - etiology

KW - prevention

KW - screening

KW - treatment

UR - http://www.scopus.com/inward/record.url?scp=84921354929&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84921354929&partnerID=8YFLogxK

U2 - 10.1146/annurev-med-070213-054849

DO - 10.1146/annurev-med-070213-054849

M3 - Article

C2 - 25587648

AN - SCOPUS:84921354929

VL - 66

SP - 161

EP - 176

JO - Annual Review of Medicine

JF - Annual Review of Medicine

SN - 0066-4219

ER -