Medical assessment of adverse health outcomes in Dutch childhood cancer survivors; a nationwide project; SKION LATER Q2008 onderzoek:
Late cardiovascular toxicity in long-term childhood cancer survivors

Advances in diagnosis and treatment of childhood cancer over the last decades
have dramatically increased long-term survival. As a result, the numbers of
childhood cancer survivors (CCS) are growing and it has become increasingly
clear that the former disease and its treatment can significantly impair
long-term health. The need for long-term follow-up is uniformly recognized.
Research focusing on identification and characterization of high-risk
populations is an essential foundation on which to build evidence-based
recommendations for long-term follow-up. Furthermore, research focusing on more
accurate screening tests and effective interventions is needed to reduce excess
morbidity and mortality in CCS. The SKION LATER Q2008 - cardiology study
phocuses on late cardiac toxicity in CCS

1- To estimate the prevalence of cardiac abnormalities, defined as systolic
dysfunction, cardiovascular risk factors in CCS who have received
anthracyclines, mitoxantrone and / or radiotherapy to the heart region compared
with sibling controls and to estimate treatment related risk factors.
2- To estimate the diagnostic value of strain measurements (tissue Doppler
echocardiographic) to detect systolic and diastolic dysfunction in CCS who have
received anthracyclines, mitoxantrone or radiotherapy to the heart region
3- To estimate the prevalence of cardiac abnormalities, defined as systolic
dysfunction, cardiovascular risk factors in CCS who have received
cyclofosfamide, ifosfamide or vincristin compared with sibling controls and to
estimate treatment related risk factors.
4- To estimate the prevalence of abnormal biomarkers in CSS who had received
cardiotoxic treatment compared with siblings controls and to estimate the
treatment related risk factors;
5- To estimate the diagnostic value abnormal biomarkers to detect systolic or
diastolic dysfunction

The study will consist of an anamnesis and physical exam, a echocardiography,
an ECG and a venapuncture. for a substantial part of the population, these
tests will be part of regular patient follow up as defined by the guidelines
for screening for late toxicity in CCS. Data will be collected anonymously in a
central database. .

the largest part of the participants (n=3000) will get a outpatient visit,
echocardiogram and venapuncture as part of their regular follow up based on
screening guidelines for CCS. only the ECG is only part of the study for these
patients (15 minutes) for the CCS treated with cyclophosphamide, ifosfamide or
vincristin, the outpatient visit and venapuncture is part of the regular follow
up based on screening guidelines for CCS. for these CCS the echocardiography
and venapuncture are done as part of the study (1.15 hrs) for the matched
sibbling controls, outpatient visit, echocardiography, ECG and venapuncture are
done in research setting (2.5 hrs) there are no risks for the study
participants.