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4 results on '"Feijen, E. A. M. Lieke"'

1. Treatments affecting splenic function as a risk factor for valvular heart disease in Childhood Cancer Survivors:A DCCSS-LATER study

Author

Houtman, Bente M., Walraven, Iris, Kapusta, Livia, Teske, Arco J., van Dulmen-den Broeder, Eline, Tissing, Wim J. E., van den Heuvel-Eibrink, Marry M., Versluys, A. B. Birgitta, Bresters, Dorine, van der Heiden-vander Loo, Margriet, Ronckers, Cecile, Kok, Wouter E. M., van der Pal, Helena J. H., Pluijm, Saskia M. F., Janssens, Geert O., Blijlevens, Nicole M. A., Kremer, Leontien C. M., Loonen, Jacqueline J., Feijen, E. A. M. Lieke, Houtman, Bente M., Walraven, Iris, Kapusta, Livia, Teske, Arco J., van Dulmen-den Broeder, Eline, Tissing, Wim J. E., van den Heuvel-Eibrink, Marry M., Versluys, A. B. Birgitta, Bresters, Dorine, van der Heiden-vander Loo, Margriet, Ronckers, Cecile, Kok, Wouter E. M., van der Pal, Helena J. H., Pluijm, Saskia M. F., Janssens, Geert O., Blijlevens, Nicole M. A., Kremer, Leontien C. M., Loonen, Jacqueline J., and Feijen, E. A. M. Lieke

Abstract

PurposeSplenectomy might be a risk factor for valvular heart disease (VHD) in adult Hodgkin lymphoma survivors. As this risk is still unclear for childhood cancer survivors (CCS), the aim of this study is to evaluate the association between treatments affecting splenic function (splenectomy and radiotherapy involving the spleen) and VHD in CCS.MethodsCCS were enrolled from the DCCSS-LATER cohort, consisting of 6,165 five-year CCS diagnosed between 1963 and 2002. Symptomatic VHD, defined as symptoms combined with a diagnostic test indicating VHD, was assessed from questionnaires and validated using medical records. Differences in the cumulative incidence of VHD between CCS who received treatments affecting splenic function and CCS who did not were assessed using the Gray test. Risk factors were analyzed in a multivariable Cox proportional hazards model.ResultsThe study population consisted of 5,286 CCS, with a median follow-up of 22 years (5-50 years), of whom 59 (1.1%) had a splenectomy and 489 (9.2%) radiotherapy involving the spleen. VHD was present in 21 CCS (0.4%). The cumulative incidence of VHD at the age of 40 years was significantly higher in CCS who received treatments affecting splenic function (2.7%, 95% confidence interval (CI) 0.4%-4.9%) compared with CCS without (0.4%, 95% CI 0.1%-0.7%) (Gray's test, p = 0.003). Splenectomy was significantly associated with VHD in a multivariable analysis (hazard ratio 8.6, 95% CI 3.1-24.1).Conclusions and implicationsSplenectomy was associated with VHD. Future research is needed to determine if CCS who had a splenectomy as part of cancer treatment might benefit from screening for VHD.

Published
2024

2. Risk and Temporal Changes of Heart Failure Among 5-Year Childhood Cancer Survivors: a DCOG-LATER Study.

Author

(Lieke) Feijen, E. A. M., Font-Gonzalez, Anna, Van der Pal, Helena J. H., Kok, Wouter E. M., Geskus, Ronald B., Ronckers, Cécile M., Bresters, Dorine, van Dalen, Elvira C., van Dulmen-den Broeder, Eline, van den Berg, Marleen H., van der Heiden-van der Loo, Margriet, van den Heuvel-Eibrink, Marry M., van Leeuwen, Flora E., Loonen, Jacqueline J., Neggers, Sebastian J. C. M. M., Versluys, A. B. (Birgitta), Tissing, Wim J. E., Kremer, Leontien C. M., Feijen, E A M Lieke, and DCOG‐LATER Study Group

Published
2019
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4. Risk and Temporal Changes of Heart Failure Among 5-Year Childhood Cancer Survivors: a DCOG-LATER Study.

Author

Feijen EAML, Font-Gonzalez A, Van der Pal HJH, Kok WEM, Geskus RB, Ronckers CM, Bresters D, van Dalen EC, van Dulmen-den Broeder E, van den Berg MH, van der Heiden-van der Loo M, van den Heuvel-Eibrink MM, van Leeuwen FE, Loonen JJ, Neggers SJCMM, Versluys ABB, Tissing WJE, and Kremer LCM

Subjects
Adolescent, Adult, Aged, Child, Female, Follow-Up Studies, Heart Failure etiology, Humans, Incidence, Male, Middle Aged, Neoplasms epidemiology, Neoplasms radiotherapy, Netherlands epidemiology, Retrospective Studies, Risk Factors, Survival Rate trends, Young Adult, Cancer Survivors statistics & numerical data, Forecasting, Heart Failure epidemiology, Neoplasms chemically induced, Risk Assessment methods
Abstract

Background Heart failure is one of the most important late effects after treatment for cancer in childhood. The goals of this study were to evaluate the risk of heart failure, temporal changes by treatment periods, and the risk factors for heart failure in childhood cancer survivors ( CCS ). Methods and Results The DCOG-LATER (Dutch Childhood Oncology Group-Long-Term Effects After Childhood Cancer) cohort includes 6,165 5-year CCS diagnosed between 1963 and 2002. Details on prior cancer diagnosis and treatment were collected for this nationwide cohort. Cause-specific cumulative incidences and risk factors of heart failure were obtained. Cardiac follow-up was complete for 5,845 CCS (94.8%). After a median follow-up of 19.8 years and at a median attained age of 27.3 years, 116 survivors developed symptomatic heart failure. The cumulative incidence of developing heart failure 40 years after childhood cancer diagnosis was 4.4% (3.4%-5.5%) among all CCS. The cumulative incidence of heart failure grade ≥3 among survivors treated in the more recent treatment periods was higher compared with survivors treated earlier (Gray test, P=0.05). Mortality due to heart failure decreased in the more recent treatment periods (Gray test, P=0.02). In multivariable analysis, survivors treated with a higher dose of mitoxantrone or cyclophosphamide had a higher risk of heart failure than survivors who were exposed to lower doses. Conclusions CCS treated with mitoxantrone, cyclophosphamide, anthracyclines, or radiotherapy involving the heart are at a high risk for severe, life-threatening or fatal heart failure at a young age. Although mortality decreased, the incidence of severe or life-threatening heart failure increased with more recent treatment periods.

Published
2019
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