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CIMT does not identify early vascular changes in childhood acute lymphoblastic leukemia survivors
Tomasz Ociepa1, Wioletta Posio2, Marcin Sawicki2
1Department of Pediatrics, Hemato-Oncology and Gastroenterology, Pomeranian Medical University, Szczecin, Poland.
Insights
Carotid intima-media thickness (CIMT) measurement has limited accuracy for assessing early vascular changes in childhood acute lymphoblastic leukemia (ALL) survivors. Further research is needed to identify reliable methods for predicting cardiovascular risk in these patients.
Area of Science:
- Cardiology
- Pediatric Oncology
- Vascular Biology
Background:
- Childhood acute lymphoblastic leukemia (ALL) survivors face an elevated risk of developing cardiovascular disease.
- Carotid intima-media thickness (CIMT) is a potential biomarker for cardiovascular risk in the general population.
Purpose of the Study:
- To evaluate CIMT in childhood ALL survivors.
- To determine the influence of blood pressure (BP) and lipid profiles on CIMT in this cohort.
Main Methods:
- The study included 81 childhood ALL survivors (aged 5-25) and 52 healthy controls.
- Measurements included CIMT, 24-hour BP monitoring, and lipid profiles.
Main Results:
- Despite a higher prevalence of arterial hypertension in ALL survivors, mean CIMT values did not differ significantly between survivors and controls.
- A positive correlation was observed between 24-hour systolic BP standard deviation score (SDS) and CIMT-SDS in ALL survivors, but not in controls.
- Body mass index (BMI) correlated with CIMT in controls, but not in ALL survivors.
Conclusions:
- CIMT measurement has limited utility for early vascular risk assessment in childhood ALL survivors.
- Alternative methods are required for early cardiovascular risk prediction in this population during follow-up.
Background:
Childhood acute lymphoblastic leukemia (ALL) survivors are at an increased risk of cardiovascular disease development. It is believed that in the general population, this risk can be predicted with carotid intima-media thickness (CIMT) measurement.
Objectives:
The objective of this study was to assess CIMT and to investigate the effects of blood pressure (BP) and lipid profile values on CIMT in childhood ALL survivors.
Material And Methods:
The study group comprised 81 childhood ALL survivors aged 5-25 years. The control group consisted of 52 ageand sex-comparable healthy children. Carotid intima-media thickness measurement, 24-hour BP monitoring and lipid profiles were evaluated in patients and controls.
Results:
Despite significantly higher proportion of subjects with arterial hypertension (AH) (30/81 vs 10/52; p = 0.0315), the mean values of CIMT were not statistically different in childhood ALL survivors as compared to controls (0.4303 ±0.03 vs 0.4291 ±0.03; p = 0.81 and 1.096 ±0.74 vs 1.027 ±0.55; p = 0.56, respectively). Carotid intima-media thickness values were not statistically higher in ALL survivors with AH as compared to ALL survivors with normal BP (0.433 ±0.03 vs 0.428 ±0.03; p = 0.82). A significant positive correlation between 24-hour systolic BP standard deviation score (SDS) and CIMT-SDS in childhood ALL survivors was found (r = 0.29, p = 0.009), whereas such correlation was not observed in healthy controls (r = 0.12, p = 0.39). A significant correlation between z-score body mass index (BMI) and CIMT was found in controls (r = 0.29, p = 0.031) but not in childhood ALL survivors (r = -0.05, p = 0.64). No significant correlations between CIMT and other measured variables were found. Carotid intima-media thickness did not significantly correlate with time since ALL diagnosis (r = 0.09, p = 0.39).
Conclusions:
Carotid intima-media thickness measurement shows limited feasibility and diagnostic accuracy for early assessment of vascular alteration in childhood ALL survivors. Other tests are needed to predict cardiovascular risk in childhood ALL survivors at the early stage of the follow-up.
