Cardiac Dysfunction, Cardiovascular Diseases, Childhood Cancer
Conditions
Keywords
Childhood cancer survivors, Late effects, Cardiotoxicity, Chemotherapy, Anthracyclines, Radiation
Brief summary
This multicenter, prospective cohort study evaluates early cardiac dysfunction in adult survivors of childhood cancer. The hypothesis of this study is that cardiac dysfunction can be detected earlier when using speckle tracking echocardiography as novel echocardiographic technique compared to conventional echocardiography.
Detailed description
Cardiovascular disease including cardiac dysfunction is the leading non-malignant cause of death in childhood cancer survivors. Early detection of cardiac dysfunction is important to identify those in need for medical intervention to improve outcome. This study invites adult childhood cancer survivors to a clinical appointment to the University Hospital Bern, Switzerland. A detailed, standardized cardiac assessment including conventional and novel echocardiographic techniques (speckle tracking) as well as cardiopulmonary exercise testing is performed. Cardiac dysfunction is evaluated in survivors who have had cardiotoxic cancer therapy with anthracyclines and/or chest radiation (high risk) and in survivors who have had chemotherapy other than anthracyclines (standard risk).
Interventions
DIAGNOSTIC_TESTcardiac assessment
Personal history, physical examination including anthropometry with hip/waist-ratio, electrocardiogram, echocardiography, 1-minute-sit-to-stand test, questionnaires on health-related quality of life (SF-36), diet, physical activity, and fatigue
Sponsors
University Hospital, Basel, Switzerland
University Children's Hospital Basel
Insel Gruppe AG, University Hospital Bern
Cantonal Hospital of St. Gallen
Luzerner Kantonsspital
University Hospital, Geneva
University of Bern
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
This prospective cohort study is nested within the Childhood Cancer Registry (ChCR), a national, population-based cancer registry that includes all children and adolescents in Switzerland who were diagnosed with cancer at age 0-20 years. It includes patients diagnosed with leukemia, lymphoma, central nervous system tumors, and malignant solid tumours or Langerhans cell histiocytosis. Childhood cancer survivors have survived at least 5 years from cancer diagnosis. Inclusion Criteria: * Registered in the ChCR * Formerly treated at the Department of Pediatric Hematology/Oncology of one of five participating centers * Treated with any chemotherapy and/or chest radiation * Survived ≥ 5 years since most recent cancer diagnosis (primary cancer, relapse(s), secondary cancer) at time of examination * Diagnosed at age ≤ 20 years * ≥ 18 years of age at time of study participation * Resident in Switzerland * Written informed consent
Exclusion criteria
* Study participants will be excluded if they do not meet the above mentioned inclusion criteria or refuse to participate in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Prevalence of cardiac dysfunction | Baseline and longitudinal follow-up where clinically indicated | Conventional echocardiography: left ventricular ejection fraction (%) |
| Prevalence of impaired exercise capacity | Baseline | Cardiopulmonary exercise testing: peak oxygen consumption, percent-predicted carbon dioxide production |
| Treatment-related risk factors | Baseline | Cumulative doses of anthracyclines, steroids, and alkylating agents (mg/m2) |
Countries
Switzerland
Contacts
Primary ContactClaudia E Kuehni, MD
Backup ContactChristina Schindera, MD
Outcome results
None listed