title: Pilot study of vascular health in survivors of osteosarcoma.
abstract: BACKGROUND
  Cardiovascular-related toxicities have been reported among survivors of osteosarcoma.
  
  
  METHODS
  Fasting blood samples from 24 osteosarcoma survivors were analyzed for high-sensitivity C-reactive protein (hsCRP), triglycerides, total cholesterol, high-density lipoprotein (HDL), apolipoprotein-ß, lipoprotein (a), fibrinogen, circulating endothelial cells (CECs), and surface expression of vascular cell adhesion molecule-1 (VCAM-1). Values were compared to subjects in the natural history Coronary Artery Risk Development in Young Adults (CARDIA) cohort study except for CECs and VCAM-1 expression, which were compared to controls studied at the University of Minnesota Lillehei clinical trials unit.
  
  
  METHODS
  Survivors (54.2% male), median age 18 years (9-32) at diagnosis, 36.5 years (20-56) at evaluation were treated with a variety of chemotherapeutic exposures, all but one were exposed to doxorubicin (median dose 450 mg/m(2) ; range: 90-645 mg/m(2)), 14 (58.3%) received cisplatin, and 3 (12.5%) were exposed to carboplatin. Two survivors (8.3%) received radiation therapy for disease relapse. Compared to CARDIA subjects, mean hsCRP (3.0 mg/L ± 2.0 vs. 1.6 ± 2.3), triglycerides (151 mg/dl ± 81.7 vs. 95.4 ± 101.3), lipoprotein (a) (34.9 mg/dl ± 17.7 vs. 13.8 ± 22.0), and fibrinogen (315.0 mg/dl ± 49.3 vs. 252.4 ± 61.7) were significantly elevated. The number of CECs (0.47 cells/ml ± 2.5 vs. 0.92 ± 2.5) did not differ while surface expression of VCAM-1 (86.4% ± 34.0 vs. 42.1 ± 33.8) was significantly elevated compared to controls.
  
  
  CONCLUSIONS
  Among survivors of osteosarcoma, assessed a median of 14 years from diagnosis, there is evidence of vascular inflammation, dyslipidemia, and early atherogenesis.
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA. daniel.mulrooney@stjude.org
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Mulrooney
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.forename: Sujuan
authors.initials: S
authors.lastname: Huang
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: Denis R
authors.initials: DR
authors.lastname: Clohisy
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; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D050197:Atherosclerosis / Q000097:blood* / Q000209:etiology; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D015331:Cohort Studies; D050171:Dyslipidemias / Q000097:blood* / Q000209:etiology; D005260:Female; D005786:Gene Expression Regulation; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D012516:Osteosarcoma / Q000097:blood* / Q000628:therapy; D010865:Pilot Projects; D017741:Survivors; D019010:Vascular Cell Adhesion Molecule-1 / Q000096:biosynthesis; D014657:Vasculitis / Q000097:blood* / Q000209:etiology
chemical_list: D000970:Antineoplastic Agents; D008055:Lipids; D019010:Vascular Cell Adhesion Molecule-1; D002097:C-Reactive Protein
keywords: osteosarcoma; survivorship; vascular late effects