title: Radiotherapy-related arterial intima thickening and plaque formation in childhood cancer survivors detected with very-high resolution ultrasound during young adulthood.
abstract: BACKGROUND
  The aim of the study was to evaluate arterial morphology and function in a national cohort of long-term survivors of high-risk neuroblastoma (NBL) treated with high-dose chemotherapy and autologous hematopoietic stem cell transplantation with or without total body irradiation (TBI).
  
  
  RESULTS
  Common carotid, femoral, brachial, and radial artery morphology were assessed with very-high-resolution vascular ultrasound (25-55 MHz), and carotid artery stiffness and brachial artery flow-mediated dilatation measured with conventional vascular ultrasound in 19 adult or pubertal (age 22.7 ± 4.9 years, range 16-30) NBL survivors transplanted during 1984-1999 at the mean age of 2.5 ± 1.0 years. Results were compared with 20 age- and sex-matched healthy controls. The cardiovascular risk assessment included history, body mass index, fasting plasma lipids, glucose, and 24-h ambulatory blood pressure (BP). The survivors had consistently smaller arterial lumens, increased carotid intima-media thickness (IMT), plaque formation (N = 3), and stiffness, as well as increased radial artery intima thickness (N = 5) compared with the control group. Survivors displayed higher plasma triglyceride and cholesterol levels, and increased heart rate, as well as increased systolic and diastolic BPs. TBI (N = 10) and a low body surface area were independent predictors for decreased arterial lumen size and increased IMT. Three out of five survivors with subclinical intima thickening had arterial plaques. Plaques occurred only among TBI-treated survivors.
  
  
  CONCLUSIONS
  Long-term childhood cancer survivors treated with TBI during early childhood display significant signs of premature arterial aging during young adulthood.
authors.affiliation: Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Anu
authors.initials: A
authors.lastname: Vatanen
authors.affiliation: Division of Cardiology, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Taisto
authors.initials: T
authors.lastname: Sarkola
authors.affiliation: Division of Cardiology, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Tiina H
authors.initials: TH
authors.lastname: Ojala
authors.affiliation: Division of Cardiology, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Maila
authors.initials: M
authors.lastname: Turanlahti
authors.affiliation: Division of Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Jahnukainen
authors.affiliation: Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Ulla M
authors.initials: UM
authors.lastname: Saarinen-Pihkala
authors.affiliation: Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.|Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden.
authors.forename: Kirsi
authors.initials: K
authors.lastname: Jahnukainen
mesh_terms: D000293:Adolescent; D000328:Adult; D064592:Autografts; D001786:Blood Glucose / Q000378:metabolism; D001916:Brachial Artery / Q000000981:diagnostic imaging; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D005215:Fasting / Q000097:blood; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D009447:Neuroblastoma / Q000628:therapy; D058226:Plaque, Atherosclerotic / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology*; D017741:Survivors; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D059289:Vascular Stiffness; D014916:Whole-Body Irradiation / Q000009:adverse effects*
chemical_list: D001786:Blood Glucose; D008055:Lipids
keywords: HSCT; atherosclerosis; cardiovascular; late effects; neuroblastoma