scholarly journals A Retrospective Evaluation of Risk of Peripartum Cardiac Dysfunction in Survivors of Childhood, Adolescent and Young Adult Malignancies

Cancers ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1046
Author(s):  
Chait-Rubinek ◽  
Mariani ◽  
Goroncy ◽  
Herschtal ◽  
Wheeler ◽  
...  
Keyword(s):  
At Risk ◽  
Young Adult ◽  
Cancer Diagnosis ◽  
Cardiac Dysfunction ◽  
Adolescent And Young Adult ◽  
Cardiac Events ◽  
Increased Risk ◽  
Cardiac Assessment ◽  
Long Term Survivors

Long-term survivors of childhood, adolescent and young adult (AYA) malignancies with past exposure to potentially cardiotoxic treatments are at risk of peripartum cardiac dysfunction. Incidence and risk factors for peripartum cardiac dysfunction and maternal cardiac outcomes in this population were investigated. Eligible long-term survivors were aged <30 years at cancer diagnosis, with ≥1 pregnancy occurring ≥5 years after diagnosis. “Peripartum” cardiac events were defined as occurring within pregnancy or ≤5months after delivery. Cardiac events were classified “symptomatic” or “subclinical”. “Peripartum cardiomyopathy” (PPCM) was defined as symptomatic dysfunction without prior cardiac dysfunction. Of 64 eligible women, 5 (7.8%) had peripartum cardiac events: 3 symptomatic, 2 subclinical. Of 110 live births, 2 (1.8%, 95% CI 0.2–6.4) were defined as PPCM: Significantly greater than the published general population incidence of 1:3000 (p < 0.001), representing a 55-fold (95% CI 6.6–192.0) increased risk. Risk factor analyses were hypothesis-generating, revealing younger age at cancer diagnosis and higher anthracycline dose. Postpartum, cardiac function of 4 women (80%) failed to return to baseline. In conclusion, peripartum cardiac dysfunction is an uncommon but potentially serious complication in long-term survivors of paediatric and AYA malignancies previously treated with cardiotoxic therapies. Peripartum cardiac assessment is strongly recommended for at-risk patients.

Limitations in health care access and utilization among long-term survivors of adolescent and young adult cancer

Cancer ◽  
2012 ◽  
Vol 118 (23) ◽  
pp. 5964-5972 ◽  
Author(s):  
Anne C. Kirchhoff ◽  
Courtney R. Lyles ◽  
Mark Fluchel ◽  
Jennifer Wright ◽  
Wendy Leisenring
Keyword(s):  
Health Care ◽  
Young Adult ◽  
Health Care Access ◽  
Adolescent And Young Adult ◽  
Care Access ◽  
Young Adult Cancer ◽  
Long Term Survivors

scholarly journals Long‐term survivors of childhood, adolescent and young adult non‐Hodgkin lymphoma

2019 ◽  
Vol 185 (6) ◽  
pp. 1099-1110 ◽  
Author(s):  
Matthew J. Ehrhardt ◽  
Jessica Hochberg ◽  
Kari L. Bjornard ◽  
Tara M. Brinkman
Keyword(s):  
Young Adult ◽  
Hodgkin Lymphoma ◽  
Adolescent And Young Adult ◽  
Non Hodgkin Lymphoma ◽  
Long Term Survivors

Health care experiences of long-term survivors of adolescent and young adult cancer

2016 ◽  
Vol 24 (9) ◽  
pp. 3967-3977 ◽  
Author(s):  
Sapna Kaul ◽  
Mark Fluchel ◽  
Holly Spraker-Perlman ◽  
Christopher F. Parmeter ◽  
Anne C. Kirchhoff
Keyword(s):  
Health Care ◽  
Young Adult ◽  
Adolescent And Young Adult ◽  
Health Care Experiences ◽  
Young Adult Cancer ◽  
Long Term Survivors

Incidence and Predictors of Mental Health Outcomes Among Survivors of Adolescent and Young Adult Cancer: A Population-Based Study Using the IMPACT Cohort

2021 ◽  
pp. JCO.20.02019
Author(s):  
Riddhita De ◽  
Rinku Sutradhar ◽  
Paul Kurdyak ◽  
Suriya Aktar ◽  
Jason D. Pole ◽  
...  
Keyword(s):  
Mental Health ◽  
Young Adult ◽  
Health Outcomes ◽  
Psychotic Disorder ◽  
Population Based ◽  
Mental Health Outcomes ◽  
Adolescent And Young Adult ◽  
Increased Risk ◽  
The Impact

PURPOSE Risk and predictors of long-term mental health outcomes in survivors of adolescent and young adult (AYA) cancers are poorly characterized. Mental health is consequently neglected in long-term follow-up. METHODS We identified all AYA in Ontario, Canada age 15-21 years when diagnosed with one of six common cancers between 1992-2012 using a population-based database, and compared them with matched controls. Linkage to provincial healthcare data allowed analysis of rates of outpatient (family physician and psychiatrist) visits for psychiatric indications and time to severe psychiatric events (emergency room visit, hospitalization, and suicide). Demographic-, disease-, and treatment-related predictors of adverse outcomes, including treatment setting (adult v pediatric), were examined. RESULTS Among 2,208 survivors and 10,457 matched controls, 5-year survivors experienced higher rates of outpatient mental health visits than controls (671 visits per 1,000 person-years v 506; adjusted rate ratio [RR] 1.3; 95% CI, 1.1 to 1.5; P = .006). Risk of a severe psychiatric episode was also increased among survivors (adjusted hazard ratio [HR], 1.2; 95% CI, 1.1 to 1.4, P = .008). Risk of a psychotic disorder–associated severe event was doubled in survivors (HR, 2.0, 95% CI, 1.3 to 2.4; P = .007) although absolute risk remained low (15-year cumulative incidence 1.7%; 95% CI, 1.0 to 2.7). In multivariable analysis, survivors treated in adult centers experienced substantially higher outpatient visit rates compared with those treated in pediatric settings (RR 1.8; 95% CI, 1.0 to 3.1; P = .04). CONCLUSION Survivors of AYA cancer are at substantially increased risk of adverse mental health outcomes, with those treated in adult centers at particular risk. Although absolute incidence was low, survivors were at increased risk of psychotic disorder–associated severe events. Long-term mental health surveillance is warranted, as is research into effective interventions during or after cancer treatment.

Marriage and fertility in long-term survivors of childhood, adolescent and young adult (AYA) high-grade sarcoma

2016 ◽  
Vol 21 (4) ◽  
pp. 801-807 ◽  
Author(s):  
Tsukasa Yonemoto ◽  
Miyako Takahashi ◽  
Mitsue Maru ◽  
Akiko Tomioka ◽  
Masahiro Saito ◽  
...  
Keyword(s):  
Young Adult ◽  
Adolescent And Young Adult ◽  
High Grade ◽  
High Grade Sarcoma ◽  
Long Term Survivors

Cardiovascular Morbidity in Long-Term Survivors of Metastatic Testicular Cancer

2000 ◽  
Vol 18 (8) ◽  
pp. 1725-1732 ◽  
Author(s):  
M.T. Meinardi ◽  
J.A. Gietema ◽  
W.T. A. van der Graaf ◽  
D.J. van Veldhuisen ◽  
M.A. Runne ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Testicular Cancer ◽  
Left Ventricular ◽  
Cardiac Events ◽  
Increased Risk ◽  
Artery Disease ◽  
Chemotherapy Patients ◽  
Long Term Survivors ◽  
Metastatic Testicular Cancer

PURPOSE: To determine whether long-term survivors of metastatic testicular cancer have an increased risk of cardiovascular morbidity more than 10 years after chemotherapy.PATIENTS AND METHODS: Eighty-seven patients treated with cisplatin-containing chemotherapy before 1987 who were in remission for at least 10 years and whose ages were ≤ 50 years at the time of analysis were evaluated for the occurrence of cardiovascular events. Sixty-two of 87 patients were additionally evaluated for cardiac damage and cardiovascular risk factors. Their cardiovascular risk profile was compared with that of 40 patients with comparable age and follow-up duration treated with orchidectomy only for stage I disease.RESULTS: Major cardiac events were found in five (6%) of the 87 patients (age at time of event, 30 to 42 years; time after chemotherapy, 9 to 16 years): two with myocardial infarction and three with angina pectoris with proven myocardial ischemia. An increased observed-to-expected ratio of 7.1 (95% confidence interval, 1.9 to 18.3) for coronary artery disease, as compared with the general male Dutch population, was found. In addition, one patient experienced a cerebrovascular accident. Exercise ECG did not reveal cases of subclinical coronary artery disease. Echocardiography showed normal systolic left ventricular function in most patients, but diastolic left ventricular function was disturbed in 33% of the patients. Of 62 chemotherapy patients, 79% had hypercholesterolemia, 39% had hypertension, 25% still experienced Raynaud’s phenomenon, and 22% had microalbuminuria. Compared with patients with stage I disease, the chemotherapy patients had higher blood pressure and higher total cholesterol and triglyceride levels and were more insulin-resistant.CONCLUSION: In long-term survivors of metastatic testicular cancer, we observed a significantly increased risk for occurrence of cardiac events accompanied by a persisting unfavorable cardiovascular risk profile. Accurate follow-up, focused on cardiovascular complications and aimed at intervention in these young cancer survivors, seems to be important.

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