07 Jan Childhood Cancer Survivors At Increased Risk of Early Onset Heart Disease

Dr. Daniel Mulrooney

MedicalResearch.com Interview with:
Daniel A. Mulrooney, MD, MS
Cancer Survivorship
Jude Children’s Research Hospital
TN 38105-3678

Medical Research: What is the background for this study? What are the main findings?

 Dr. Mulrooney:  This is a cross-sectional analysis performed in the St. Jude Lifetime Cohort Study (SJLIFE), an ongoing study designed to facilitate longitudinal evaluation of health outcomes among adults previously treated for childhood cancer.  Following patients over the life spectrum can be challenging making it difficult to understand the long-term health effects of childhood cancer therapy.  Previous studies have relied on self-report, registry, or death certificate data.  Our study is novel because we clinically evaluated cancer survivors on the St. Jude campus and identified substantial, asymptomatic cardiac disease (cardiomyopathy, coronary artery disease, valvular disease, and conduction/rhythm disorders).

• Cardiomyopathy was present in 7.4% of survivors and newly identified by screening in 4.7%.
• Coronary artery disease was present in 3.8% of survivors and newly identified by screening in 2.2%.
• Valvular disease (regurgitation or stenosis) was present in 28% of survivors and newly identified by screening in 24.8%.
• Conduction or rhythm abnormalities were present in 4.4% of survivors and newly identified by screening in 1.4%.

The prevalence of these cardiac findings might be expected in an older population but not necessarily in this young adult (median age at time of study 31 years, range: 18-60) population.   

Medical Research: What should clinicians and patients take away from your report?

Dr. Mulrooney: It is important for cancer survivors who have been previously exposed to cardiotoxic therapies – anthracycline chemotherapies and/or cardiac-directed radiation therapy – to be monitored and have regular cardiac screening.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Mulrooney: Our research suggests a potential future health care burden for cancer survivors.  Research should focus on identifying those at greatest/lowest risk, the best screening practices for these populations, and therapeutic measures to ameliorate or prevent cardiac disease in cancer survivors.

Citation:

Melissa M. Hudson, MD et al.
Cardiac Outcomes in Adult Survivors of Childhood Cancer Exposed to Cardiotoxic Therapy: A Cross-sectional Study.
Annals of Internal Medicine, January 2016 DOI:10.7326/M15-0424

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Daniel A. Mulrooney, MD, MS (2016). Childhood Cancer Survivors At Increased Risk of Early Onset Heart Disease 

Last Updated on January 7, 2016 by Marie Benz MD FAAD