Heart failure following cancer therapy in patients with hematological malignancies aged 18 years and under : a linked health data analysis (1996-2009)

Berry, Narelle M, Ullah, Shahid, Versace, Vincent, McCarthy, Alexandra L, Atherton, John, Roder, David, Koczwara, Bogda, Coghlan, Douglas, Chowdhury, Munir H. and Clark, Robyn A 2016, Heart failure following cancer therapy in patients with hematological malignancies aged 18 years and under : a linked health data analysis (1996-2009), in Abstracts from the American Heart Association's Epidemiology and Prevention/ Lifestyle and Cardiometabolic Health 2016 Scientific Sessions, American Heart Association, Dallas, Tex., pp. 1-1.

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Title Heart failure following cancer therapy in patients with hematological malignancies aged 18 years and under : a linked health data analysis (1996-2009)
Author(s) Berry, Narelle M
Ullah, Shahid
Versace, VincentORCID iD for Versace, Vincent orcid.org/0000-0002-8514-1763
McCarthy, Alexandra L
Atherton, John
Roder, David
Koczwara, Bogda
Coghlan, Douglas
Chowdhury, Munir H.
Clark, Robyn A
Conference name American Heart Association. Epidemiology and Prevention, Lifestyle and Cardiometabolic Health Scientific Sessions (2016 : Phoenix, Arizona)
Conference location Phoenix, Arizona
Conference dates 1-4 Mar. 2016
Title of proceedings Abstracts from the American Heart Association's Epidemiology and Prevention/ Lifestyle and Cardiometabolic Health 2016 Scientific Sessions
Publication date 2016
Start page 1
End page 1
Total pages 1
Publisher American Heart Association
Place of publication Dallas, Tex.
Summary Introduction: The causal link between chemotherapy treatments and subsequent cardiotoxicity is well established, particularly for children with hematological malignancies. Little information exists on the characteristics and outcomes for patients with heart failure (HF) after chemotherapy. This study aimed to describe the characteristics, survival and mortality of patients who received chemotherapy for hematological cancer (leukemias, lymphomas and related disorders) before 18 years old and subsequently developed HF compared to those who did not.

Methods: Linked health data (1996-2009) from the Queensland Cancer Registry, Death Registry and Hospital Administration records for HF and chemotherapy admissions were reviewed. From all breast and hematological cancers patients (n=73,158), 15,987 received chemotherapy, including 819 patients aged ≤18 years at time of cancer diagnosis. Patients were categorized as those with an index HF admission (occurred after cancer diagnosis) and those without an index HF admission (non HF).

Results: Of the 819 patients, 3.7% (n=30) had an index HF admission. Median age of HF patients at time of cancer diagnosis was 5 years (IQR 3-12) compared to 7 years (IQR 3-14) in the non HF group (p=0.503). Median follow up from cancer diagnosis was 2.5 years in the HF group compared to 5.42 years in the non HF group (p<0.01). Of those who developed HF, 70% (n=21) had the index admission within 12 months of their cancer diagnosis. Of those with HF, 53.3% (n=16) died (all cause) compared to 14.6% (n=115) with no HF. On adjustment for age, sex and chemotherapy admissions, HF patients had an almost 5 fold increased mortality risk compared to non HF patients (HR 4.91 [95% CI, 2.88-8.36]) (Figure 1).

Conclusions: This study demonstrated that in children with hematological cancers the onset of HF occurred soon after chemotherapy and mortality risk is almost 5 times that of children who do not develop HF. Innovative strategies are still needed for the prevention and management of cardiotoxicity in this population.
Language eng
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 929999 Health not elsewhere classified
HERDC Research category E3 Extract of paper
Copyright notice ©2016, American Heart Association
Persistent URL http://hdl.handle.net/10536/DRO/DU:30082577

Document type: Conference Paper
Collections: Faculty of Health
School of Medicine
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