Anthracycline chemotherapy does not increase arterial stiffness or carotid intima-media thickness in young adult survivors of hematological malignancies.

Anthracyclines, a common chemotherapy used to treat hematological malignancies in young adults (YAs), have well-documented cardiotoxicity. Previous studies also suggest large artery stiffness is impaired following anthracycline therapy, but these data are inconclusive. We hypothesized that cancer survivors' postanthracycline therapy would exhibit an accelerated vascular aging phenotype characterized by higher large artery stiffness and carotid intima-media thickness (IMT) compared with noncancer controls. A total of 25 YA cancer (acute leukemia and lymphoma) survivors from the University of Iowa Hospitals and Clinics and 25 age (27 ± 6 years), sex (54% female), and body mass index [25(8) kg/m2]-matched controls were recruited. Arterial stiffness was measured using carotid-femoral pulse wave velocity (aortic stiffness) and carotid artery ultrasonography (pressure-independent β-stiffness index). Supine blood pressure was measured in triplicate via auscultation. Between-group comparisons were assessed using an independent samples t test. The median total anthracycline dose received (as doxorubicin equivalents) was 214 (172) mg/m2, with a median follow-up of 7 years posttreatment. Compared with the control group, YA cancer survivors did not exhibit greater aortic stiffness (cancer: 5.7 ± 0.7 m/s; control: 5.6 ± 0.9 m/s, P = 0.44), pressure-independent β-stiffness index (cancer: 6.6 ± 1.6 U; control: 6.6 ± 2.0 U, P = 0.99), nor carotid IMT (P = 0.14). In addition, we did not observe evidence of accelerated arterial stiffening among cancer survivors (Z score = 0.97, P = 0.34). These results suggest that accelerated vascular aging is not a side effect of anthracycline therapy among this cohort of YA cancer survivors.NEW & NOTEWORTHY Cancer survivors treated with anthracycline chemotherapy have increased risk for cardiovascular disease in later life. Findings from the present study show that arterial stiffness is not elevated among individuals post anthracycline chemotherapy, suggesting that large artery stiffness does not contribute to the increased cardiovascular risk observed in this population.