Key result
Anthracyclines in childhood ALL survivors are linked to ~31% lower TAPSE and reduced endothelial function.
Why the study?
Childhood acute lymphoblastic leukemia survivors who underwent chemotherapy with anthracyclines have an increased cardiovascular risk, prompting evaluation of left and right cardiac chamber performances and vascular endothelial function.
Does prior anthracycline chemotherapy impair cardiac chamber performance and vascular endothelial function in childhood ALL survivors compared to healthy controls?
Case-Control (n=91)
Does prior anthracycline chemotherapy impair cardiac chamber performance and vascular endothelial function in childhood ALL survivors compared to healthy controls?
Absolute Event Rate: 16.9% vs 24.5%
p-value: p=<0.0001
Childhood ALL survivors treated with anthracyclines show subclinical right ventricular and endothelial dysfunction, emphasizing the importance of early cardiovascular monitoring.
May support enhanced RV surveillance in anthracycline-exposed ALL survivors; leaves open causal links and progression in prospective cohorts.
Childhood acute lymphoblastic leukemia (ALL) survivors who underwent chemotherapy with anthracyclines have an increased cardiovascular risk. The aim of the study was to evaluate left and right cardiac chamber performances and vascular endothelial function in childhood ALL survivors. Fifty-four ALL survivors and 37 healthy controls were enrolled. All patients underwent auxological evaluation, blood pressure measurements, biochemical parameters of endothelial dysfunction, flow-mediated dilatation (FMD) of the brachial artery, mean common carotid intima-media thickness (c-IMT), antero-posterior diameter of the infra-renal abdominal aorta (APAO), and echocardiographic assessment. The ALL subjects had significantly lower FMD (p = 0.0041), higher left (p = 0.0057) and right (p = 0.0021) echocardiographic/Doppler Tei index (the non-invasive index for combined systolic and diastolic ventricular function) as compared to controls. Tricuspid annular plane excursion (TAPSE) was 16.9 ± 1.2 mm vs. 24.5 ± 3.7 mm, p < 0.0001. Cumulative anthracycline doses were related to TAPSE (p < 0.001). The ALL survivors treated with anthracyclines demonstrated systo/diastolic alterations of the right ventricle and reduced endothelial function compared with healthy controls. The early recognition of subclinical cardiac and vascular impairment during follow up is of utmost importance for the cardiologist to implement strategies preventing overt cardiovascular disease considering the growing number of young adults cured after childhood ALL.
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Muggeo et al. (2022) conducted a case-control in Childhood acute lymphoblastic leukemia (ALL) survivors (n=91). Anthracycline chemotherapy vs. Healthy controls was evaluated on Tricuspid annular plane excursion (TAPSE) (p=<0.0001). Childhood ALL survivors treated with anthracyclines had significantly lower TAPSE (16.9 vs 24.5 mm, p<0.0001) and reduced endothelial function compared to healthy controls.
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