Klin Padiatr 2020; 232(02): 105
DOI: 10.1055/s-0040-1701894
S-VIII
Session VIII: Survivorship and Aftercare
© Georg Thieme Verlag KG Stuttgart · New York

Hyperlipoproteinemia, insulin resistance and metabolic syndrome in long-term survivors of Hodgkin lymphoma during childhood and adolescence

M Cepelova
1   2nd Medical Faculty Charles University and University Hospital in Motol,Department of Pediatric Hematology and Oncology, Prague, Czech Republi
,
J Kruseova
1   2nd Medical Faculty Charles University and University Hospital in Motol,Department of Pediatric Hematology and Oncology, Prague, Czech Republi
,
A Luks
1   2nd Medical Faculty Charles University and University Hospital in Motol,Department of Pediatric Hematology and Oncology, Prague, Czech Republi
,
V Capek
1   2nd Medical Faculty Charles University and University Hospital in Motol,Department of Pediatric Hematology and Oncology, Prague, Czech Republi
,
P Cepela
2   3rd Medical Faculty Charles University and University Hospital Kralovske Vinohrady, 2nd Internal Clinic, Prague, Germany
,
J Potockova
2   3rd Medical Faculty Charles University and University Hospital Kralovske Vinohrady, 2nd Internal Clinic, Prague, Germany
,
P Kraml
2   3rd Medical Faculty Charles University and University Hospital Kralovske Vinohrady, 2nd Internal Clinic, Prague, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2020 (online)

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    Introduction Long-term survivors of Hodgkin lymphoma during childhood or adolescence (HL survivors) are at high risk of developing treatment-related late cardiovascular sequelae.

    Methods 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.

    Results The HL survivors showedunfavorable 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), insulin resistance (p=0.0002), hyperglycemia (p=0.0002) and metabolic syndrome (p=0.01). 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).

    Conclusion Adult survivors of Hodgkin lymphoma during childhood and adolescence need follow-up with screening of metabolic syndrome components and unfavorable lifestyle factors and early management of these risk factors.

    This study was supported by grant NV15-30494A from the Ministry of Health of the Czech Republic.


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