Anthracycline Chemotherapy does not Increase Arterial Stiffness or Carotid Intima-Media Thickness in Young Adult Survivors of Hematological Malignancies

Introduction. Anthracyclines, a common chemotherapy used to treat hematological malignancies in young adults (YA), have well documented cardiotoxicity. Previous studies also suggest large artery stiffness is impaired following anthracycline therapy, but these data are inconclusive. We hypothesized that cancer survivors’ post-anthracycline therapy would exhibit an accelerated vascular ageing phenotype characterized by higher large artery stiffness and carotid intima-media thickness (IMT) compared with non-cancer controls. Methods. A total of 25 YA cancer (acute leukemia and lymphoma) survivors from the University of Iowa Hospitals and Clinics and 25 age (27 ± 6 years), sex (54% female), and body mass index [25(8) kg/m 2 ]-matched controls were recruited. Arterial stiffness was measured using carotid-femoral pulse wave velocity (aortic stiffness) and carotid artery ultrasonography (pressure-independent beta-stiffness index). Supine blood pressure was measured in triplicate via the auscultation. Between-group comparisons were assessed using independent samples t-test. Results. The median total anthracycline dose received (as doxorubicin equivalents) was 214 (172) mg/m², with a median follow-up of 7 years post-treatment. Compared to the control group, YA cancer survivors did not exhibit greater aortic stiffness (cancer: 5.7 ± 0.7 m/s; control: 5.6 ± 0.9 m/s, p=0.44), pressure-independent beta-stiffness index (cancer: 6.6 ± 1.6 U; control: 6.6 ± 2.0 U, p=0.99), nor carotid IMT (p=0.14). Additionally, we did not observe evidence of accelerated arterial stiffening among cancer survivors (Z score=0.97, p=0.34). Conclusion. These results suggest that accelerated vascular aging is not a side effect of anthracycline therapy among this cohort of YA cancer survivors.