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11 hits in Medvik Filters

Article

Total body irradiation is a crucial risk factor for developing secondary carcinomas after allogeneic hematopoietic stem cell transplantation in childhood

Keslova, P
Author Keslova, P Department of Pediatric Hematology and Oncology, University Hospital Motol, 2nd Medical School, Charles University Prague, Prague, Czech Republic
Formankova, R
Author Formankova, R Department of Pediatric Hematology and Oncology, University Hospital Motol, 2nd Medical School, Charles University Prague, Prague, Czech Republic
Riha, P
Author Riha, P Department of Pediatric Hematology and Oncology, University Hospital Motol, 2nd Medical School, Charles University Prague, Prague, Czech Republic
Sramkova, L
Author Sramkova, L Department of Pediatric Hematology and Oncology, University Hospital Motol, 2nd Medical School, Charles University Prague, Prague, Czech Republic
Snajderova, M
Author Snajderova, M Department of Pediatrics, University Hospital Motol, 2nd Medical School, Charles University Prague, Prague, Czech Republic
Malinova, B
Author Malinova, B Department of Oncology, University Hospital Motol, 2nd Medical School, Charles University Prague, Prague, Czech Republic
Luks, A
Author Luks, A Department of Pediatric Hematology and Oncology, University Hospital Motol, 2nd Medical School, Charles University Prague, Prague, Czech Republic
Sterba, J
Author Sterba, J Department of Pediatric Oncology, University Hospital Brno and School of Medicine, Masaryk University, Brno, Czech Republic
Stary, J
Author Stary, J Department of Pediatric Hematology and Oncology, University Hospital Motol, 2nd Medical School, Charles University Prague, Prague, Czech Republic
Sedlacek, P
Author Sedlacek, P Department of Pediatric Hematology and Oncology, University Hospital Motol, 2nd Medical School, Charles University Prague, Prague, Czech Republic

Neoplasma. 2020 ; 67 (5) : 1164-1169. [pub] 20200714

ISSN 0028-2685
Medvik
Source

Allogeneic hematopoietic stem cell transplantation (HSCT) has become a standard part of therapy for a variety of malignant and non-malignant disorders. With improved outcomes after HSCT, increasing attention has been drawn to late complications in long-term survivors. The development of secondary malignancies is recognized as one of the most serious complications. We have evaluated data from 426 patients (272 males, 154 females) who underwent allogeneic transplantation at a median age of 7.9 years from 1989 till 2017 and were alive more than one year after transplantation for the occurrence of secondary solid tumors. We have documented the occurrence of secondary solid tumors in 20 patients (4.7%). The median duration of the development of secondary solid cancer from HSCT was 11.7 (range, 5.4-21.5 years). 18 out of 20 patients (90%) had total body irradiation (TBI) 12-14.4 Gy as a part of a conditioning regimen. All but two had transplantation for malignant disease. All patients underwent surgery and/or chemo-radiotherapy. Eighteen are alive, and two died due to the progression of their secondary malignancy. The most frequent solid cancer was thyroid carcinoma (n=9). Cumulative incidence of secondary solid cancer in all groups was 15.2±3.9%, in a group using TBI based regimen 34.7±8.9%, in non-TBI (only chemo) group was 1.5±1.1%. Overall, the cumulative incidence is statistically significantly different between the TBI based and non-TBI (chemo only) group. The incidence and number of complications following allogeneic HSCT in childhood are increasing in time. The early diagnosis of secondary malignancies is one of the key tasks of long-life multidisciplinary post-transplant care.

MeSH
Whole-Body Irradiation adverse effects MeSH
Child MeSH
Transplantation, Homologous MeSH
Humans MeSH
Neoplasms, Radiation-Induced * MeSH
Transplantation Conditioning adverse effects MeSH
Risk Factors MeSH
Neoplasms, Second Primary etiology MeSH
Hematopoietic Stem Cell Transplantation * MeSH
Check Tag
Child MeSH
Humans MeSH
Male MeSH
Female MeSH
Publication type
Journal Article MeSH

Article

Accelerated atherosclerosis, hyperlipoproteinemia and insulin resistance in long-term survivors of Hodgkin lymphoma during childhood and adolescence

Neoplasma. 2019 ; 2019 (-) : . [pub] 20190712

ISSN 0028-2685
Medvik
Source

Long-term survivors of Hodgkin lymphoma during childhood or adolescence (HL survivors) are at high risk of developing treatment-related late cardiovascular sequelae. In our study we evaluated the presence of modifiable cardiovascular risk factors (hypertension, hyperlipoproteinemia, hyperinsulinemia, obesity), endothelial and inflammatory markers (E-selectin, PAI-1, hs-CRP) and atherosclerotic changes in the common carotid arteries. Assessment was performed in 80 young adult Hodgkin lymphoma long-term survivors at more than 10 years after the potentially cardiovascular toxic anticancer treatment (median age at evaluation 34.7 years; range 24.1-40.9 years). The HL survivors were compared with 83 age- and gender-matched healthy volunteers. The HL survivors showed unfavorable lipid profiles compared to those of healthy controls: triglycerides (p=0.01), total cholesterol (p=0.0004), low density lipoprotein cholesterol (p=0.005). In HL survivors, we found a higher prevalence of hypertension (p=0.004) and insulin resistance - HOMA-IR (p=0.0002). Ultrasonographic examination of both common carotid arteries revealed a higher prevalence of atherosclerotic plaques (p=0.0009) and higher carotid intima-media thickness (p<0.0001) in HL survivors. Markers of oxidative stress (advanced oxidation protein products, oxidized low-density lipoprotein), inflammation (hs-CRP) and endothelial dysfunction (E-selectin, PAI-1) were also higher in HL survivors (p<0.0001, p=0.0002, p=0.0031, p=0.0087, p=0.004, respectively). Adult survivors of Hodgkin lymphoma during childhood and adolescence need closer follow-up with screening of metabolic syndrome components, unfavorable lifestyle factors and early management of these risk factors.