Pilot study of vascular health in survivors of Hodgkin lymphoma

Background Vascular-related toxicities have been reported among survivors of Hodgkin lymphoma (HL), but their genesis is not well understood. Procedure Fasting blood samples from 25 previously irradiated HL survivors were analyzed for biomarkers that can reveal underlying inflammation and/or endothelial cell activation: high-sensitivity C-reactive protein (hsCRP), triglycerides, total cholesterol, high-density lipoprotein (HDL), apolipoprotein beta, lipoprotein (a), fibrinogen, circulating endothelial cells (CECs), and vascular cell adhesion molecule-1 (VCAM-1) expression. Values were compared to subjects in the Coronary Artery Risk Development in Young Adults (CARDIA) study. CECs and VCAM-1 were compared to healthy controls. Results Survivors (76% male), median age 17.6 years (533) at diagnosis, 33.0 years (1955) at follow-up, included stages IA (n?=?6), IIA (n?=?10), IIB (n?=?2), IIIA (n?=?4), and IVA (n?=?3) patients. Twenty-four received at least chest radiation therapy (RT) (median dose 3,150 cGy; range: 175-4,650 cGy), one received neck only; 14 (56%) had a history of anthracycline exposure (median dose: 124?mg/m2 range: 63200?mg/m2). Compared to CARDIA subjects, mean hsCRP (3.0?mg/L +/- 2.0 vs. 1.6 +/- 1.9), total cholesterol (194.1?mg/dl +/- 33.2 vs. 179.4 +/- 32.9), lipoprotein (a) (34.2?mg/dl +/- 17.5 vs. 13.8 +/- 17.5), and fibrinogen (342.0?mg/dl +/- 49.1 vs. 252.6 +/- 48.4) were significantly elevated. CECs (2.3 cells/ml +/- 1.5 vs. 0.34 +/- 1.4) were significantly elevated compared to controls. No difference in VCAM-1 expression (51.1%+/- 36.8 vs. 42.3 > 35.6) was detected. Conclusion HL survivors exposed to RT have evidence of vascular inflammation, dyslipidemia, and injury suggestive of early atherogenesis. Pediatr Blood Cancer 2012;59:285289. (c) 2012 Wiley Periodicals, Inc.