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Long-term cardiovascular risk in survivors of hematologic malignancies: a meta-analysis
Siqing Liu1, Shuran Liu1, Yining Hu1
1School of Public Health and Nursing, Zhejiang Key Laboratory of Medical Epigenetics, Hangzhou Normal University, Building No.7 in Shenyuan, 2318 Yuhangtang Road, Hangzhou, 311121, China.
Background:
The survival rate for hematologic malignancies is steadily improving. With the encouraging trend and the aging of these survivors, there is an ever-increasing responsibility for identifying adverse cardiovascular outcomes associated with carcinogenesis and/or anti-cancer therapies across the span of their lives. However, prospective studies have yielded inconsistent results.
Methods:
We performed a meta-analysis to summarize the evidence regarding the association between leukemia, Hodgkin lymphoma (HL), and non-Hodgkin lymphoma (NHL) in relation to later risk of cardiovascular disease (CVD). Relevant literatures were identified from PubMed and Web of Science databases through May 2024 and reviewing reference lists of retrieved articles.
Results:
From the 2412 studies screened, we included 50 studies with 550,385 participants, spanning 1940-2020 for leukemia and 1940-2016 for both Hodgkin and non-Hodgkin lymphoma. The pooled fully adjusted RRs of total CVD, ischemic heart disease (IHD), heart failure (HF), and stroke associated with leukemia were 2.68 (95% confidence interval: 2.22-3.25), 1.46 (1.25-1.70), 4.13 (2.41-7.06), and 3.05 (2.16-4.32), respectively. For HL or NHL survivors, similar positive associations were observed in our study. In addition, compared with survivors with chemotherapy (2.12; 1.89-2.38), radiotherapy-treated survivors had a greater risk of CVD (4.06; 2.84-5.81).
Conclusions:
In summary, survivors of hematologic malignancies, especially those who receive radiotherapy, are at highest risk of developing CVD, emphasizing the need for targeted prevention strategies.
