LONDON – Childhood cancer survivors face an increased risk of developing heart failure starting at a much younger age than the cardiac disease typically appears, according to a Dutch national cohort study.
“Health care professionals need to be aware of these findings and recognize the risk of developing heart failure in young people, even years after their childhood cancer treatment,” Dr. Elizabeth A.M. Feijen advised at the annual congress of the European Society of Cardiology.
Bruce Jancin/Frontline Medical News
She presented an analysis from the Dutch Childhood Oncology Group LATER (Late Effects of Childhood Cancer) study which entailed collecting followup data on more than 5,000 Dutch 5-year survivors of childhood cancer. After a median followup of 20 years, and at an average age of 27.4 years, 2% of the national cohort had been diagnosed with heart failure.
Of 113 childhood cancer survivors with heart failure, 9 had undergone heart transplantation, 11 required a pacemaker and/or implantable cardioverter-defibrillator, and 22 had died due to their heart failure, reported Dr. Feijen of the Academic Medical Center of Amsterdam.
The cumulative incidence of heart failure was 1.1% by age 20, 2.3% by age 30, 3.9% by age 40, and 5.4% by 50 years of age.
In a multivariate regression analysis, the significant risk factors for heart failure after childhood cancer were treatment with anthracyclines, with an associated 1.8-fold increased risk per 100 mg/m2 of medication; mitoxantrone, with a 2.3-fold risk per 25 mg/m2; chest radiation to the heart, with a 1.9-fold risk; and the use of cyclophosphamide, with an associated 1.8-fold increased risk of subsequent heart failure.
The DCOG LATER study is supported by the Dutch Cancer Society and the Children Cancer Free Foundation. Dr. Feijen reported having no financial conflicts.