Hypertension in long-term childhood cancer survivors after treatment with potentially nephrotoxic therapy; DCCSS-LATER 2: Renal study

Dutch LATER Study Group; Esmee C.M. Kooijmans; Helena J.H. van der Pal; Saskia M.F. Pluijm; Dorine Bresters; Eline van Dulmen-den Broeder; Margriet van der Heiden-van der Loo; Marry M. van den Heuvel-Eibrink; Leontien C.M. Kremer; Jacqueline J. Loonen; Marloes Louwerens; Sebastian J.C. Neggers; Maxime Pilon; Cécile Ronckers; Wim J.E. Tissing; Andrica C.H. de Vries; Gertjan J.L. Kaspers; Arend Bökenkamp; Margreet A. Veening

doi:10.1016/j.ejca.2022.05.038

Hypertension in long-term childhood cancer survivors after treatment with potentially nephrotoxic therapy; DCCSS-LATER 2: Renal study

Dutch LATER Study Group, Esmee C.M. Kooijmans^*, Helena J.H. van der Pal, Saskia M.F. Pluijm, Dorine Bresters, Eline van Dulmen-den Broeder, Margriet van der Heiden-van der Loo, Marry M. van den Heuvel-Eibrink, Leontien C.M. Kremer, Jacqueline J. Loonen, Marloes Louwerens, Sebastian J.C. Neggers, Maxime Pilon, Cécile Ronckers, Wim J.E. Tissing, Andrica C.H. de Vries, Gertjan J.L. Kaspers, Arend Bökenkamp, Margreet A. Veening

^*Corresponding author for this work

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Abstract

Purpose: To evaluate the prevalence of and risk factors for hypertension in childhood cancer survivors (CCSs) who were treated with potentially nephrotoxic therapies.

Methods: In the Dutch Childhood Cancer Survivor Study LATER cohort part 2 renal study, 1024 CCS ≥5 years after diagnosis, aged ≥18 years at study participation, treated between 1963 and 2001 with nephrectomy, abdominal radiotherapy, total body irradiation (TBI), cisplatin, carboplatin, ifosfamide, high-dose cyclophosphamide (≥1 g/m² per single dose or ≥10 g/m² total) or haematopoietic stem cell transplantation participated and 500 controls from Lifelines. Hypertension was defined as blood pressure (BP) (mmHg) systolic ≥140 and/or diastolic ≥90 or receiving medication for diagnosed hypertension. At the study visit, the CKD-EPI 2012 equation including creatinine and cystatin C was used to estimate the glomerular filtration rate (GFR). Multivariable regression analyses were used.

For ambulatory BP monitoring (ABPM), hypertension was defined as BP daytime: systolic ≥135 and/or diastolic ≥85, night time: systolic ≥120 and/or diastolic ≥70, 24-h: systolic ≥130 and/or diastolic ≥80. Outcomes were masked hypertension (MH), white coat hypertension and abnormal nocturnal dipping (aND).

Results: Median age at cancer diagnosis was 4.7 years (interquartile range, IQR 2.4–9.2), at study 32.5 years (IQR 27.7–38.0) and follow-up 25.5 years (IQR 21.4–30.3). The prevalence of hypertension was comparable in CCS (16.3%) and controls (18.2%). In 12% of CCS and 17.8% of controls, hypertension was undiagnosed. A decreased GFR (<60 ml/min/1.73 m²) was associated with hypertension in CCS (OR 3.4, 95% CI 1.4–8.5). Risk factors were abdominal radiotherapy ≥20 Gy and TBI. The ABPM-pilot study (n = 77) showed 7.8% MH, 2.6% white coat hypertension and 20.8% aND.

Conclusion: The prevalence of hypertension was comparable among CCS who were treated with potentially nephrotoxic therapies compared to controls, some of which were undiagnosed. Risk factors were abdominal radiotherapy ≥20 Gy and TBI. Hypertension and decreased GFR were associated with CCS. ABPM identified MH and a ND.

Original language	English
Pages (from-to)	287-299
Number of pages	13
Journal	European Journal of Cancer
Volume	172
DOIs	https://doi.org/10.1016/j.ejca.2022.05.038
Publication status	Published - Sept-2022

Keywords

Ambulatory blood pressure monitoring
Childhood cancer survivor
Hypertension
Late effects
Nephrotoxicity

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Dutch LATER Study Group, Kooijmans, E. C. M., van der Pal, H. J. H., Pluijm, S. M. F., Bresters, D., van Dulmen-den Broeder, E., van der Heiden-van der Loo, M., van den Heuvel-Eibrink, M. M., Kremer, L. C. M., Loonen, J. J., Louwerens, M., Neggers, S. J. C., Pilon, M., Ronckers, C., Tissing, W. J. E., de Vries, A. C. H., Kaspers, G. J. L., Bökenkamp, A., & Veening, M. A. (2022). Hypertension in long-term childhood cancer survivors after treatment with potentially nephrotoxic therapy; DCCSS-LATER 2: Renal study. European Journal of Cancer, 172, 287-299. https://doi.org/10.1016/j.ejca.2022.05.038

@article{b28c764e16844de6a56e9c82e54d49a5,

title = "Hypertension in long-term childhood cancer survivors after treatment with potentially nephrotoxic therapy; DCCSS-LATER 2: Renal study",

abstract = "Purpose: To evaluate the prevalence of and risk factors for hypertension in childhood cancer survivors (CCSs) who were treated with potentially nephrotoxic therapies.Methods: In the Dutch Childhood Cancer Survivor Study LATER cohort part 2 renal study, 1024 CCS ≥5 years after diagnosis, aged ≥18 years at study participation, treated between 1963 and 2001 with nephrectomy, abdominal radiotherapy, total body irradiation (TBI), cisplatin, carboplatin, ifosfamide, high-dose cyclophosphamide (≥1 g/m2 per single dose or ≥10 g/m2 total) or haematopoietic stem cell transplantation participated and 500 controls from Lifelines. Hypertension was defined as blood pressure (BP) (mmHg) systolic ≥140 and/or diastolic ≥90 or receiving medication for diagnosed hypertension. At the study visit, the CKD-EPI 2012 equation including creatinine and cystatin C was used to estimate the glomerular filtration rate (GFR). Multivariable regression analyses were used.For ambulatory BP monitoring (ABPM), hypertension was defined as BP daytime: systolic ≥135 and/or diastolic ≥85, night time: systolic ≥120 and/or diastolic ≥70, 24-h: systolic ≥130 and/or diastolic ≥80. Outcomes were masked hypertension (MH), white coat hypertension and abnormal nocturnal dipping (aND).Results: Median age at cancer diagnosis was 4.7 years (interquartile range, IQR 2.4–9.2), at study 32.5 years (IQR 27.7–38.0) and follow-up 25.5 years (IQR 21.4–30.3). The prevalence of hypertension was comparable in CCS (16.3%) and controls (18.2%). In 12% of CCS and 17.8% of controls, hypertension was undiagnosed. A decreased GFR (<60 ml/min/1.73 m2) was associated with hypertension in CCS (OR 3.4, 95% CI 1.4–8.5). Risk factors were abdominal radiotherapy ≥20 Gy and TBI. The ABPM-pilot study (n = 77) showed 7.8% MH, 2.6% white coat hypertension and 20.8% aND.Conclusion: The prevalence of hypertension was comparable among CCS who were treated with potentially nephrotoxic therapies compared to controls, some of which were undiagnosed. Risk factors were abdominal radiotherapy ≥20 Gy and TBI. Hypertension and decreased GFR were associated with CCS. ABPM identified MH and a ND.",

keywords = "Ambulatory blood pressure monitoring, Childhood cancer survivor, Hypertension, Late effects, Nephrotoxicity",

author = "{Dutch LATER Study Group} and Kooijmans, {Esmee C.M.} and {van der Pal}, {Helena J.H.} and Pluijm, {Saskia M.F.} and Dorine Bresters and {van Dulmen-den Broeder}, Eline and {van der Heiden-van der Loo}, Margriet and {van den Heuvel-Eibrink}, {Marry M.} and Kremer, {Leontien C.M.} and Loonen, {Jacqueline J.} and Marloes Louwerens and Neggers, {Sebastian J.C.} and Maxime Pilon and C{\'e}cile Ronckers and Tissing, {Wim J.E.} and {de Vries}, {Andrica C.H.} and Kaspers, {Gertjan J.L.} and Arend B{\"o}kenkamp and Veening, {Margreet A.}",

note = "Funding Information: This study was supported by KWF Dutch Cancer Society (grant number 7889 ). Publisher Copyright: {\textcopyright} 2022 The Author(s)",

year = "2022",

month = sep,

doi = "10.1016/j.ejca.2022.05.038",

language = "English",

volume = "172",

pages = "287--299",

journal = "European Journal of Cancer",

issn = "0959-8049",

publisher = "ELSEVIER SCI LTD",

}

Dutch LATER Study Group, Kooijmans, ECM, van der Pal, HJH, Pluijm, SMF, Bresters, D, van Dulmen-den Broeder, E, van der Heiden-van der Loo, M, van den Heuvel-Eibrink, MM, Kremer, LCM, Loonen, JJ, Louwerens, M, Neggers, SJC, Pilon, M, Ronckers, C, Tissing, WJE, de Vries, ACH, Kaspers, GJL, Bökenkamp, A & Veening, MA 2022, 'Hypertension in long-term childhood cancer survivors after treatment with potentially nephrotoxic therapy; DCCSS-LATER 2: Renal study', European Journal of Cancer, vol. 172, pp. 287-299. https://doi.org/10.1016/j.ejca.2022.05.038

TY - JOUR

T1 - Hypertension in long-term childhood cancer survivors after treatment with potentially nephrotoxic therapy; DCCSS-LATER 2

T2 - Renal study

AU - Dutch LATER Study Group

AU - Kooijmans, Esmee C.M.

AU - van der Pal, Helena J.H.

AU - Pluijm, Saskia M.F.

AU - Bresters, Dorine

AU - van Dulmen-den Broeder, Eline

AU - van der Heiden-van der Loo, Margriet

AU - van den Heuvel-Eibrink, Marry M.

AU - Kremer, Leontien C.M.

AU - Loonen, Jacqueline J.

AU - Louwerens, Marloes

AU - Neggers, Sebastian J.C.

AU - Pilon, Maxime

AU - Ronckers, Cécile

AU - Tissing, Wim J.E.

AU - de Vries, Andrica C.H.

AU - Kaspers, Gertjan J.L.

AU - Bökenkamp, Arend

AU - Veening, Margreet A.

PY - 2022/9

Y1 - 2022/9

N2 - Purpose: To evaluate the prevalence of and risk factors for hypertension in childhood cancer survivors (CCSs) who were treated with potentially nephrotoxic therapies.Methods: In the Dutch Childhood Cancer Survivor Study LATER cohort part 2 renal study, 1024 CCS ≥5 years after diagnosis, aged ≥18 years at study participation, treated between 1963 and 2001 with nephrectomy, abdominal radiotherapy, total body irradiation (TBI), cisplatin, carboplatin, ifosfamide, high-dose cyclophosphamide (≥1 g/m2 per single dose or ≥10 g/m2 total) or haematopoietic stem cell transplantation participated and 500 controls from Lifelines. Hypertension was defined as blood pressure (BP) (mmHg) systolic ≥140 and/or diastolic ≥90 or receiving medication for diagnosed hypertension. At the study visit, the CKD-EPI 2012 equation including creatinine and cystatin C was used to estimate the glomerular filtration rate (GFR). Multivariable regression analyses were used.For ambulatory BP monitoring (ABPM), hypertension was defined as BP daytime: systolic ≥135 and/or diastolic ≥85, night time: systolic ≥120 and/or diastolic ≥70, 24-h: systolic ≥130 and/or diastolic ≥80. Outcomes were masked hypertension (MH), white coat hypertension and abnormal nocturnal dipping (aND).Results: Median age at cancer diagnosis was 4.7 years (interquartile range, IQR 2.4–9.2), at study 32.5 years (IQR 27.7–38.0) and follow-up 25.5 years (IQR 21.4–30.3). The prevalence of hypertension was comparable in CCS (16.3%) and controls (18.2%). In 12% of CCS and 17.8% of controls, hypertension was undiagnosed. A decreased GFR (<60 ml/min/1.73 m2) was associated with hypertension in CCS (OR 3.4, 95% CI 1.4–8.5). Risk factors were abdominal radiotherapy ≥20 Gy and TBI. The ABPM-pilot study (n = 77) showed 7.8% MH, 2.6% white coat hypertension and 20.8% aND.Conclusion: The prevalence of hypertension was comparable among CCS who were treated with potentially nephrotoxic therapies compared to controls, some of which were undiagnosed. Risk factors were abdominal radiotherapy ≥20 Gy and TBI. Hypertension and decreased GFR were associated with CCS. ABPM identified MH and a ND.

AB - Purpose: To evaluate the prevalence of and risk factors for hypertension in childhood cancer survivors (CCSs) who were treated with potentially nephrotoxic therapies.Methods: In the Dutch Childhood Cancer Survivor Study LATER cohort part 2 renal study, 1024 CCS ≥5 years after diagnosis, aged ≥18 years at study participation, treated between 1963 and 2001 with nephrectomy, abdominal radiotherapy, total body irradiation (TBI), cisplatin, carboplatin, ifosfamide, high-dose cyclophosphamide (≥1 g/m2 per single dose or ≥10 g/m2 total) or haematopoietic stem cell transplantation participated and 500 controls from Lifelines. Hypertension was defined as blood pressure (BP) (mmHg) systolic ≥140 and/or diastolic ≥90 or receiving medication for diagnosed hypertension. At the study visit, the CKD-EPI 2012 equation including creatinine and cystatin C was used to estimate the glomerular filtration rate (GFR). Multivariable regression analyses were used.For ambulatory BP monitoring (ABPM), hypertension was defined as BP daytime: systolic ≥135 and/or diastolic ≥85, night time: systolic ≥120 and/or diastolic ≥70, 24-h: systolic ≥130 and/or diastolic ≥80. Outcomes were masked hypertension (MH), white coat hypertension and abnormal nocturnal dipping (aND).Results: Median age at cancer diagnosis was 4.7 years (interquartile range, IQR 2.4–9.2), at study 32.5 years (IQR 27.7–38.0) and follow-up 25.5 years (IQR 21.4–30.3). The prevalence of hypertension was comparable in CCS (16.3%) and controls (18.2%). In 12% of CCS and 17.8% of controls, hypertension was undiagnosed. A decreased GFR (<60 ml/min/1.73 m2) was associated with hypertension in CCS (OR 3.4, 95% CI 1.4–8.5). Risk factors were abdominal radiotherapy ≥20 Gy and TBI. The ABPM-pilot study (n = 77) showed 7.8% MH, 2.6% white coat hypertension and 20.8% aND.Conclusion: The prevalence of hypertension was comparable among CCS who were treated with potentially nephrotoxic therapies compared to controls, some of which were undiagnosed. Risk factors were abdominal radiotherapy ≥20 Gy and TBI. Hypertension and decreased GFR were associated with CCS. ABPM identified MH and a ND.

KW - Ambulatory blood pressure monitoring

KW - Childhood cancer survivor

KW - Hypertension

KW - Late effects

KW - Nephrotoxicity

U2 - 10.1016/j.ejca.2022.05.038

DO - 10.1016/j.ejca.2022.05.038

M3 - Article

C2 - 35810554

AN - SCOPUS:85133872236

SN - 0959-8049

VL - 172

SP - 287

EP - 299

JO - European Journal of Cancer

JF - European Journal of Cancer

ER -

Hypertension in long-term childhood cancer survivors after treatment with potentially nephrotoxic therapy; DCCSS-LATER 2: Renal study

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Keywords

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