Heart Failure Following Blood Cancer Therapy in Paediatric and Adult Populations

J. Franzon, N. Berry, S. Ullah, V. Versace, A. McCarthy, J. Atherton, D. Roder, B. Koczwara, D. Coghlan, R. Clark

Research output: Contribution to journalAbstract

Abstract

Background: The link between chemotherapy treatment and cardiotoxicity is well established, particularly for adults with blood cancers. However, it is less clear for children. This analysis aimed to compare the trajectory and mortality of children and adults who received chemotherapy for blood cancers and were subsequently hospitalised for heart failure (HF).

Methods: Linked data from the Queensland Cancer Registry, Death Registry and Hospital Administration records were reviewed (1996-2009). Of all identified blood cancer patients (n = 23,434); 8,339 received chemotherapy, including 817 children (aged ≤18 years at time of cancer diagnosis) and 7,522 adults. Time-varying Cox proportional hazards regression models were used to compare the characteristics and survival between the two groups.

Results: 30 children (3.7%) and 852 adults (11.3%) were admitted for heart failure after chemotherapy treatment. 70% of these children recorded their index admission in the first 12 months after cancer diagnosis compared with 46.4% of the adults. 53% of the paediatric HF population and 71% of the adult HF population died within the study period. Following adjustment for age, sex and chemotherapy admissions, children with HF had an increased mortality risk compared to their non-HF counterparts, a difference which was much greater than that between the adult groups.

Conclusion: The impact of HF on children previously treated for blood cancer is more severe than for adults, with earlier morbidity and greater mortality. Improved strategies are needed for the prevention and management of cardiotoxicity in this population.
Original languageEnglish
Article number210
Pages (from-to)S135-S136
Number of pages2
JournalHeart, Lung and Circulation
Volume26
Issue numberSupplement 2
Early online date2 Aug 2017
DOIs
Publication statusPublished - 2017

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