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Hodgkin lenfoma sonrası kalpte ve akciğerde görülen geç yan etkiler

Year 2019, Volume: 44 Issue: 4, 1468 - 1472, 29.12.2019
https://doi.org/10.17826/cumj.513985

Abstract

Günümüzde çocukluk çağı kanserlerinin tedavisi, klinik, biyolojik, genetik faktörler ve tedaviye yanıtı dikkate alınarak risk odaklı bir yaklaşım olarak gelişmiştir. Uzun dönem çocukluk çağı kanseri hastalarında kalp hastalıkları kanser dışı ölümlerin en sık nedenidir. Kemoterapi ve radyoterapinin toksik etkileri ile kardiyomiyopati, konjestif kalp yetmezliği, perikardiyal efüzyon, konstriktif perikardit, koroner arter hastalığı, miyokard enfarktüsü ve aritmi gelişebilir. Önceki yıllarda yüksek doz radyoterapiye bağlı olarak görülen radyasyon pnömonisi, pulmoner fibrozis ve spontan pnömotoraks gibi akciğer komplikasyonları günümüzde nadiren görülmektedir. Hodgkin lenfoma hastaları gibi mediastinal radyoterapi ve/veya kardiyotoksik ajanlarla tedavi edilen hastaların uzun süreli takibi hayati öneme sahiptir. Sol ventrikül ve kalp kapak fonksiyonları ekokardiyografi ile, QTc ve ritim anormallikleri elektrokardiyografi ile izlenmeli, kardiyovasküler sağlığı etkileyebilecek diğer faktörler ve solunum fonksiyon testleri periyodik olarak değerlendirilmelidir. Bilgisayarlı tomografi anjiyografi, aldıkları tedaviler ve özellikle mediastinal radyoterapi nedeniyle risk altında olan Hodgkin lenfoma yaşayanlarında olası koroner anormalliklerin erken teşhis edilmesinde önemli bir role sahiptir. 

References

  • 1. Hodgson DC. Hodgkin lymphoma: The follow-up of long term survivors. Hematol Oncol Clin N Am. 2008; 22:233-244.
  • 2. Metzger ML, Krasin MJ, Choi JK, Hudson MM. Hodgkin lymphoma. In: Principles and practice of pediatric oncology, 7th edition. Pizzo PA, Poplack DG editors. Wolters Kluwer, Philadelphia, 2016, pp: 568-586.
  • 3. Gilladoga AC, Manuel C, Tan CT, Wollner N, Sternberg SS, Murphy ML. The cardiotoxicity of adriamycin and daunomycin in children. Cancer. 1976;37(suppl):1070–1078.
  • 4. Brosius FC 3rd, Waller BF, Roberts WC. Radiation heart disease: analysis of 16 young (aged 15 to 33 years) necropsy patients who received over 3,500 rads to the heart. Am J Med. 1981;70:519–530.
  • 5. Armstrong GT, Liu Q, Yasui Y, Neglia JP, Leisenring W, Robison LL, Mertens AC. Late mortality among 5-year survivors of childhood cancer: a summary from the Childhood Cancer Survivor Study. J Clin Oncol. 2009;27:2328–2338.
  • 6. Lipshultz SE, Adams MJ, Colan SD, Constine LS, Herman EH, Hsu DT. Long-term cardiovascular toxicity in children, adolescents, and young adults who receive cancer therapy: pathophysiology, course, monitoring, management, prevention, and research directions: a scientific statement from the American Heart Association. Circulation. 2013;128:1927-1995.
  • 7. Meyer RM, Gospodarowicz MK, Connors JM, Pearcey RG, Wells WA, Winter JN. ABVD alone versus radiation-based therapy in limited-stage Hodgkin's lymphoma. N Engl J Med. 2012;366:399-408.
  • 8. Fulbright JM. Review of cardiotoxicity in pediatric cancer patients: during and after therapy. Cardiol Res Pract. 2011;2011:942090.
  • 9. Fajardo LF, Berthrong M. Vascular lesions following radiation. Pathol Annu. 1988; 23:297-330.
  • 10. Hull MC, Morris CG, Pepine CJ, Mendenhall NP. Valvular dysfunction and carotid, subclavian, and coronary artery disease in survivors of Hodgkin lymphoma treated with radiation therapy. JAMA. 2003; 290:2831-2837.
  • 11. Heidenreich PA, Hancock SL, Lee BK, Mariscal CS, Schnittger I. Asymptomatic cardiac disease following mediastinal irradiation. J Am Coll Cardiol. 2003; 42:743-749.
  • 12. Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT et al. Chronic health conditions in adult survivors of childhoood cancer. N Eng J Med. 2006; 355:1572-1582.
  • 13. Wu S, Ko YS, Teng MS, Ko YL, Hsu LA, Hsueh C, Chou YY, Liew CC, Lee YS. Adriamycin-induced cardiomyocyte and endothelial cell apoptosis: in vitro and in vivo studies. J Mol Cell Cardiol. 2002; 34:1595-1607.
  • 14. Avilés A, Neri N, Nambo JM. Late cardiac toxicity secondary to treatment in Hodgkin's disease. A study comparing doxorubicin, epirubicin and mitoxantrone in combined therapy. Leuk Lymphoma. 2005; 46:1023-1028.
  • 15. Scholz KH, Herrmann C, Tebbe U. Myocardial infarction in young patients with Hodgkin's disease--potential pathogenic role of radiotherapy, chemotherapy, and splenectomy. Clin Investig. 1993; 71:57-64.
  • 16. Kupeli S, Hazırolan T, Varan A, Akata D, Alehan D, Hayran M, Besim A, Büyükpamukçu M. Evaluation of coronary artery disease by computed tomography angiography ın patients treated for childhood hodgkin lymphoma. J Clin Oncol. 2010; 28:1025-1030
  • 17. Kupeli S, Varan A, Hazırolan T, Büyükpamukçu M. Malignant coronary artery anomaly in a survivor of Hodgkin's lymphoma. Pediatr Cardiol. 2010; 31:569-570.
  • 18. Tebbi CK, Mendenhall NP, London WB, Williams JL, Hutchison RE, Fitzgerald TJ, de Alarcón PA, Schwartz C, Chauvenet A. Response-dependent and reduced treatment in lower risk Hodgkin lymphoma in children and adolescents, results of P9426: a report from the Children's Oncology Group. Pediatr Blood Cancer. 2012;59:1259-1265.
  • 19. Hudson MM, Ness KK, Gurney JG, Mulrooney DA, Chemaitilly W, Krull KR, Green DM, Armstrong GT, Nottage KA, Jones KE, Sklar CA, Srivastava DK, Robison LL. Clinical ascertainment of health outcomes among adults treated for childhood cancer. JAMA. 2013;309:2371-2381.
  • 20. Landier W, Armenian SH, Lee J, Thomas O, Wong FL, Francisco L, Herrera C, Kasper C, Wilson KD, Zomorodi M, Bhatia S. Yield of screening for long-term complications using the children's oncology group long-term follow-up guidelines. J Clin Oncol. 2012;30:4401-4408.
  • 21. Bossi G, Cerveri I, Volpini E, Corsico A, Baio A, Corbella F, Klersy C, Arico M. Long-term pulmonary sequelae after treatment of childhood Hodgkin's disease. Ann Oncol. 1997;8 Suppl 1:19-24.
  • 22. Miller RW, Fusner JE, Fink RJ, Murphy TM, Getson PR, Vojtova JA, Reaman GH. Pulmonary function abnormalities in long-term survivors of childhood cancer. Med Pediatr Oncol. 1986;14:202-207.
  • 23. Venkatramani R, Kamath S, Wong K, Olch AJ, Malvar J, Sposto R, Goodarzian F, Freyer DR, Keens TG, Mascarenhas L. Pulmonary outcomes in patients with Hodgkin lymphoma treated with involved field radiation. Pediatr Blood Cancer. 2014;61:1277-1281.
  • 24. Movsas B, Raffin TA, Epstein AH, Link CJ Jr. Pulmonary radiation injury. Chest. 1997;111:1061-1076.
  • 25. Oguz A, Tayfun T, Citak EC, Karadeniz C, Tatlicioglu T, Boyunaga O, Bora H. Long-term pulmonary function in survivors of childhood Hodgkin disease and non-Hodgkin lymphoma. Pediatr Blood Cancer. 2007;49:699-703.
  • 26. Ilhan I, Sarialioğlu F, Bilgiç H, Göçmen A, Büyükpamukcu M, Akyüz C, Kutluk T. Long-term pulmonary function in children with Hodgkin's disease. Acta Paediatr. 1996;85:324-326.

Cardiac and pulmonary late side effects after Hodgkin lymphoma

Year 2019, Volume: 44 Issue: 4, 1468 - 1472, 29.12.2019
https://doi.org/10.17826/cumj.513985

Abstract

Current treatment of childhood cancers has developed as a risk-oriented approach considering clinical, biological, genetic factors and treatment response. Cardiac diseases are the most common cause of non-cancer death in long-term childhood cancer patients. Cardiomyopathy, congestive heart failure, pericardial effusion, constrictive pericarditis, coronary artery disease, myocardial infarction, and arrhythmias may develop with the toxic effects of chemotherapy and radiotherapy. Pulmonary complications such as radiation pneumonitis, pulmonary fibrosis and spontaneous pneumothorax, which are seen in previous years due to high dose radiotherapy are currently rarely seen. Long-term follow-up of patients who are treated with mediastinal radiotherapy and/or cardiotoxic agents, such as patients with Hodgkin lymphoma, is of vital importance. Left ventricular and heart valve functions should be monitored by echocardiography, QTc and rhythm abnormalities should be monitored by electrocardiography and other factors that may affect cardiovascular health and pulmonary function tests should be evaluated periodically. Computerized tomography angiography has a role of in the early identification of possible coronary  abnormalities in Hodgkin lymphoma patients at risk for coronary artery disease due to the treatments they received, especially mediastinal radiotherapy.

References

  • 1. Hodgson DC. Hodgkin lymphoma: The follow-up of long term survivors. Hematol Oncol Clin N Am. 2008; 22:233-244.
  • 2. Metzger ML, Krasin MJ, Choi JK, Hudson MM. Hodgkin lymphoma. In: Principles and practice of pediatric oncology, 7th edition. Pizzo PA, Poplack DG editors. Wolters Kluwer, Philadelphia, 2016, pp: 568-586.
  • 3. Gilladoga AC, Manuel C, Tan CT, Wollner N, Sternberg SS, Murphy ML. The cardiotoxicity of adriamycin and daunomycin in children. Cancer. 1976;37(suppl):1070–1078.
  • 4. Brosius FC 3rd, Waller BF, Roberts WC. Radiation heart disease: analysis of 16 young (aged 15 to 33 years) necropsy patients who received over 3,500 rads to the heart. Am J Med. 1981;70:519–530.
  • 5. Armstrong GT, Liu Q, Yasui Y, Neglia JP, Leisenring W, Robison LL, Mertens AC. Late mortality among 5-year survivors of childhood cancer: a summary from the Childhood Cancer Survivor Study. J Clin Oncol. 2009;27:2328–2338.
  • 6. Lipshultz SE, Adams MJ, Colan SD, Constine LS, Herman EH, Hsu DT. Long-term cardiovascular toxicity in children, adolescents, and young adults who receive cancer therapy: pathophysiology, course, monitoring, management, prevention, and research directions: a scientific statement from the American Heart Association. Circulation. 2013;128:1927-1995.
  • 7. Meyer RM, Gospodarowicz MK, Connors JM, Pearcey RG, Wells WA, Winter JN. ABVD alone versus radiation-based therapy in limited-stage Hodgkin's lymphoma. N Engl J Med. 2012;366:399-408.
  • 8. Fulbright JM. Review of cardiotoxicity in pediatric cancer patients: during and after therapy. Cardiol Res Pract. 2011;2011:942090.
  • 9. Fajardo LF, Berthrong M. Vascular lesions following radiation. Pathol Annu. 1988; 23:297-330.
  • 10. Hull MC, Morris CG, Pepine CJ, Mendenhall NP. Valvular dysfunction and carotid, subclavian, and coronary artery disease in survivors of Hodgkin lymphoma treated with radiation therapy. JAMA. 2003; 290:2831-2837.
  • 11. Heidenreich PA, Hancock SL, Lee BK, Mariscal CS, Schnittger I. Asymptomatic cardiac disease following mediastinal irradiation. J Am Coll Cardiol. 2003; 42:743-749.
  • 12. Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT et al. Chronic health conditions in adult survivors of childhoood cancer. N Eng J Med. 2006; 355:1572-1582.
  • 13. Wu S, Ko YS, Teng MS, Ko YL, Hsu LA, Hsueh C, Chou YY, Liew CC, Lee YS. Adriamycin-induced cardiomyocyte and endothelial cell apoptosis: in vitro and in vivo studies. J Mol Cell Cardiol. 2002; 34:1595-1607.
  • 14. Avilés A, Neri N, Nambo JM. Late cardiac toxicity secondary to treatment in Hodgkin's disease. A study comparing doxorubicin, epirubicin and mitoxantrone in combined therapy. Leuk Lymphoma. 2005; 46:1023-1028.
  • 15. Scholz KH, Herrmann C, Tebbe U. Myocardial infarction in young patients with Hodgkin's disease--potential pathogenic role of radiotherapy, chemotherapy, and splenectomy. Clin Investig. 1993; 71:57-64.
  • 16. Kupeli S, Hazırolan T, Varan A, Akata D, Alehan D, Hayran M, Besim A, Büyükpamukçu M. Evaluation of coronary artery disease by computed tomography angiography ın patients treated for childhood hodgkin lymphoma. J Clin Oncol. 2010; 28:1025-1030
  • 17. Kupeli S, Varan A, Hazırolan T, Büyükpamukçu M. Malignant coronary artery anomaly in a survivor of Hodgkin's lymphoma. Pediatr Cardiol. 2010; 31:569-570.
  • 18. Tebbi CK, Mendenhall NP, London WB, Williams JL, Hutchison RE, Fitzgerald TJ, de Alarcón PA, Schwartz C, Chauvenet A. Response-dependent and reduced treatment in lower risk Hodgkin lymphoma in children and adolescents, results of P9426: a report from the Children's Oncology Group. Pediatr Blood Cancer. 2012;59:1259-1265.
  • 19. Hudson MM, Ness KK, Gurney JG, Mulrooney DA, Chemaitilly W, Krull KR, Green DM, Armstrong GT, Nottage KA, Jones KE, Sklar CA, Srivastava DK, Robison LL. Clinical ascertainment of health outcomes among adults treated for childhood cancer. JAMA. 2013;309:2371-2381.
  • 20. Landier W, Armenian SH, Lee J, Thomas O, Wong FL, Francisco L, Herrera C, Kasper C, Wilson KD, Zomorodi M, Bhatia S. Yield of screening for long-term complications using the children's oncology group long-term follow-up guidelines. J Clin Oncol. 2012;30:4401-4408.
  • 21. Bossi G, Cerveri I, Volpini E, Corsico A, Baio A, Corbella F, Klersy C, Arico M. Long-term pulmonary sequelae after treatment of childhood Hodgkin's disease. Ann Oncol. 1997;8 Suppl 1:19-24.
  • 22. Miller RW, Fusner JE, Fink RJ, Murphy TM, Getson PR, Vojtova JA, Reaman GH. Pulmonary function abnormalities in long-term survivors of childhood cancer. Med Pediatr Oncol. 1986;14:202-207.
  • 23. Venkatramani R, Kamath S, Wong K, Olch AJ, Malvar J, Sposto R, Goodarzian F, Freyer DR, Keens TG, Mascarenhas L. Pulmonary outcomes in patients with Hodgkin lymphoma treated with involved field radiation. Pediatr Blood Cancer. 2014;61:1277-1281.
  • 24. Movsas B, Raffin TA, Epstein AH, Link CJ Jr. Pulmonary radiation injury. Chest. 1997;111:1061-1076.
  • 25. Oguz A, Tayfun T, Citak EC, Karadeniz C, Tatlicioglu T, Boyunaga O, Bora H. Long-term pulmonary function in survivors of childhood Hodgkin disease and non-Hodgkin lymphoma. Pediatr Blood Cancer. 2007;49:699-703.
  • 26. Ilhan I, Sarialioğlu F, Bilgiç H, Göçmen A, Büyükpamukcu M, Akyüz C, Kutluk T. Long-term pulmonary function in children with Hodgkin's disease. Acta Paediatr. 1996;85:324-326.
There are 26 citations in total.

Details

Primary Language English
Subjects Paediatrics, Oncology and Carcinogenesis
Journal Section Review
Authors

Serhan Küpeli 0000-0001-7271-1803

Publication Date December 29, 2019
Acceptance Date March 18, 2019
Published in Issue Year 2019 Volume: 44 Issue: 4

Cite

MLA Küpeli, Serhan. “Cardiac and Pulmonary Late Side Effects After Hodgkin Lymphoma”. Cukurova Medical Journal, vol. 44, no. 4, 2019, pp. 1468-72, doi:10.17826/cumj.513985.