Are survivors of acute lymphoblastic leukemia (ALL) at increased risk of cardiovascular disease?
Are survivors of acute lymphoblastic leukemia (ALL) at increased risk of cardiovascular disease?
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DOI：
10.1002/pbc.21410
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发表时间：
2008-02-01
影响因子：
3.2
通讯作者：
Oeffinger, Kevin C.
中科院分区：
文献类型：
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作者：
Oeffinger, Kevin C.
通过各种不同的机制，儿童急性淋巴细胞白血病的幸存者似乎具有几种心血管危险因素的患病率增加，因此患心血管疾病的风险增加。本文的目的是描述当前对特定危险因素的理解，包括肥胖、缺乏身体活动、血脂异常、胰岛素抵抗和代谢综合征，这些因素可能有助于儿童ALL幸存者的心血管疾病。讨论了不同癌症治疗在这些危险因素发展中的潜在作用。此外，本文还讨论了另外两种可能影响心血管健康的晚期效应：迟发性蒽环类药物诱导的左心室功能障碍和治疗期间甲氨喋呤介导的同型半胱氨酸升高，可能导致内皮功能障碍。最后，强调了需要进一步调查以阐明这些风险的领域。
Through a variety of different mechanisms, it appears that survivors of childhood acute lymphoblastic leukemia have an increased prevalence of several cardiovascular risk factors and thus are at increased risk for developing cardiovascular disease. The aim of this paper is to describe the current understanding of particular risk factors, including obesity, physical inactivity, dyslipidemia, insulin resistance, and metabolic syndrome, that may contribute to cardiovascular disease in survivors of childhood ALL. The potential roles of different cancer therapies in the development of these risk factors are discussed. In addition, two other late effects that may affect cardiovascular health are discussed: late-onset anthracycline-induced left ventricular dysfunction and methotrexate-mediated elevations of homocysteine during therapy with the potential for endothelial dysfunction. Lastly, areas needing further investigation to elucidate these risks are highlighted.