Detailing the link between the treatment for acute lymphoblastic leukemia in childhood and atherosclerosis later in life

In this study, researchers from the Medical University of Lublin in Poland compared patients who underwent antineoplastic treatment with healthy individuals in terms of parameters used to evaluate subclinical atherosclerosis. The results of their study were published in the journal Annals of Agricultural and Environmental Medicine.

• Late cardiovascular complications, such as the development of atherosclerosis and atherosclerosis-related diseases, are the leading causes of morbidity and mortality among patients with common childhood malignancies.
• Evaluation of the endothelium can be based on the measurement of endothelium-derived blood vasoactive factors, such as cytokines and adhesion molecules.
• Elevated serum levels of these factors may indicate early atherosclerotic lesions in high risk patients.
• Assessment of the common carotid intima-media thickness can also be used for the evaluation of subclinical atherosclerosis.
• For their study, the researchers evaluated the early progression of atherosclerosis in 64 survivors treated for acute lymphoblastic leukemia (ALL) in childhood, and in 36 healthy volunteers (control).
• They measured blood serum levels of the following biomarkers of endothelial damage and inflammation:
  • Intercellular adhesion molecule-1 (sICAM-1)
  • Endothelial leukocyte adhesion molecule-1 (E-selectin)
  • Thrombomodulin (TM)
  • Interleukin 6 (IL-6)
  • High-sensitivity C-reactive protein (hs-CRP)
• They also assessed the common carotid intima-media thickness (IMT) via ultrasound examination.
• The researchers found that all survivors had significantly higher blood levels of sICAM-1, IL-6, and hs-CRP than the volunteers.
• All survivors also had higher mean IMT values for the left and right carotid arteries than the healthy subjects.

Based on their results, the researchers concluded that individuals treated for childhood malignancies are at a higher risk of prematurely developing atherosclerosis, as indicated by elevated serum levels of the biomarkers and increased IMT values.

Journal Reference:

Sadurska E, Zaucha-Prazmo A, Brodzisz A, Kowalczyk J, Ben-Skowronek I. PREMATURE ATHEROSCLEROSIS AFTER TREATMENT FOR ACUTE LYMPHOBLASTIC LEUKEMIA IN CHILDHOOD. Annals of Agricultural and Environmental Medicine. 2018;25(1):71–76. DOI: 10.5604/12321966.1230680