title: Pilot study of vascular health in survivors of Hodgkin lymphoma.
abstract: BACKGROUND
  Vascular-related toxicities have been reported among survivors of Hodgkin lymphoma (HL), but their genesis is not well understood.
  
  
  METHODS
  Fasting blood samples from 25 previously irradiated HL survivors were analyzed for biomarkers that can reveal underlying inflammation and/or endothelial cell activation: high-sensitivity C-reactive protein (hsCRP), triglycerides, total cholesterol, high-density lipoprotein (HDL), apolipoprotein ß, lipoprotein (a), fibrinogen, circulating endothelial cells (CECs), and vascular cell adhesion molecule-1 (VCAM-1) expression. Values were compared to subjects in the Coronary Artery Risk Development in Young Adults (CARDIA) study. CECs and VCAM-1 were compared to healthy controls.
  
  
  RESULTS
  Survivors (76% male), median age 17.6 years (5-33) at diagnosis, 33.0 years (19-55) at follow-up, included stages IA (n = 6), IIA (n = 10), IIB (n = 2), IIIA (n = 4), and IVA (n = 3) patients. Twenty-four received at least chest radiation therapy (RT) (median dose 3,150 cGy; range: 175-4,650 cGy), one received neck only; 14 (56%) had a history of anthracycline exposure (median dose: 124 mg/m(2) range: 63-200 mg/m2). Compared to CARDIA subjects, mean hsCRP (3.0 mg/L ± 2.0 vs. 1.6 ± 1.9), total cholesterol (194.1 mg/dl ± 33.2 vs. 179.4 ± 32.9), lipoprotein (a) (34.2 mg/dl ± 17.5 vs. 13.8 ± 17.5), and fibrinogen (342.0 mg/dl ± 49.1 vs. 252.6 ± 48.4) were significantly elevated. CECs (2.3 cells/ml ± 1.5 vs. 0.34 ± 1.4) were significantly elevated compared to controls. No difference in VCAM-1 expression (51.1% ± 36.8 vs. 42.3 ± 35.6) was detected.
  
  
  CONCLUSIONS
  HL survivors exposed to RT have evidence of vascular inflammation, dyslipidemia, and injury suggestive of early atherogenesis.
authors.affiliation: School of Public Health, Masonic Cancer Center, and University of Minnesota Medical School, Minneapolis, Minnesota 55455, USA. mulro006@umn.edu
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Mulrooney
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.forename: Anna
authors.initials: A
authors.lastname: Solovey
authors.forename: Robert P
authors.initials: RP
authors.lastname: Hebbel
authors.forename: James D
authors.initials: JD
authors.lastname: Neaton
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Peterson
authors.forename: Chung K K
authors.initials: CK
authors.lastname: Lee
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Kelly
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Neglia
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000150:complications* / Q000401:mortality* / Q000532:radiotherapy; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology / Q000401:mortality; D017270:Lipoprotein(a) / Q000097:blood; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010865:Pilot Projects; D011879:Radiotherapy Dosage; D015996:Survival Rate; D017741:Survivors; D014280:Triglycerides / Q000097:blood; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D014652:Vascular Diseases / Q000097:blood / Q000209:etiology* / Q000401:mortality*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D017270:Lipoprotein(a); D014280:Triglycerides; D019010:Vascular Cell Adhesion Molecule-1; D005340:Fibrinogen; D002097:C-Reactive Protein