Journal article
Cancer and Post-Therapy Cardiotoxicity Risk in Adolescents, Young Adults, and Adults With Down Syndrome
Comprehensive Physiology, Vol.15(5), e70037
10/01/2025
DOI: 10.1002/cph4.70037
PMCID: PMC12413507
PMID: 40913257
Appears in UI Libraries Support Open Access
Abstract
The median life expectancy of people with Down syndrome has increased substantially over the past several decades, from 4 years in 1970 to 53 years in 2010. Despite the recent improvement in survival, there is little data about the prevalence of age-related diseases, including age-related malignancies, and the impact of standard cancer treatments on cardiovascular health. We retrospectively reviewed medical records for age- and sex-matched patients ≥ 15 years old with and without Down syndrome using the TriNetX platform to identify the prevalence of malignancies and explore cardiovascular outcomes after treatment with anthracyclines. We further stratified the populations into adolescent and young adult (AYA, ages 15-39 years old) and adult (≥ 40 years old) cohorts, given that treatment recommendations can be different. Down syndrome patients in the AYA cohort were more likely to be diagnosed with acute myeloid leukemia (OR 8.9, CI 4.99-15.89, p < 0.001) and lymphoid leukemia (OR 7.33, CI 4.82-11.15, p < 0.001) The adult cohort with Down syndrome was more likely to be diagnosed with myelodysplastic syndromes (OR 12.25, CI 6.41-23.42, p < 0.001), multiple myeloma (OR 1.66, CI 1.06-2.6, p = 0.026), and testicular cancer (OR 2.73, CI 1.32-5.65, p = 0.005). Overall, Down syndrome patients (≥ 15 years old) treated with anthracyclines were more likely to be diagnosed with heart failure (OR 2.14, CI 1.07-4.27, p = 0.042). Our study demonstrates adolescents and adults with down syndrome have a higher predisposition to several malignancies and an increased risk of cardiovascular disease after anthracycline treatment and may require specific screening guidelines to address their unique health risks.The median life expectancy of people with Down syndrome has increased substantially over the past several decades, from 4 years in 1970 to 53 years in 2010. Despite the recent improvement in survival, there is little data about the prevalence of age-related diseases, including age-related malignancies, and the impact of standard cancer treatments on cardiovascular health. We retrospectively reviewed medical records for age- and sex-matched patients ≥ 15 years old with and without Down syndrome using the TriNetX platform to identify the prevalence of malignancies and explore cardiovascular outcomes after treatment with anthracyclines. We further stratified the populations into adolescent and young adult (AYA, ages 15-39 years old) and adult (≥ 40 years old) cohorts, given that treatment recommendations can be different. Down syndrome patients in the AYA cohort were more likely to be diagnosed with acute myeloid leukemia (OR 8.9, CI 4.99-15.89, p < 0.001) and lymphoid leukemia (OR 7.33, CI 4.82-11.15, p < 0.001) The adult cohort with Down syndrome was more likely to be diagnosed with myelodysplastic syndromes (OR 12.25, CI 6.41-23.42, p < 0.001), multiple myeloma (OR 1.66, CI 1.06-2.6, p = 0.026), and testicular cancer (OR 2.73, CI 1.32-5.65, p = 0.005). Overall, Down syndrome patients (≥ 15 years old) treated with anthracyclines were more likely to be diagnosed with heart failure (OR 2.14, CI 1.07-4.27, p = 0.042). Our study demonstrates adolescents and adults with down syndrome have a higher predisposition to several malignancies and an increased risk of cardiovascular disease after anthracycline treatment and may require specific screening guidelines to address their unique health risks.
Details
- Title: Subtitle
- Cancer and Post-Therapy Cardiotoxicity Risk in Adolescents, Young Adults, and Adults With Down Syndrome
- Creators
- Michelle A Buckman - University of IowaAnastasiia Vasileva - University of IowaCharles R Jedlicka - University of Iowa, Health, Sport, and Human PhysiologyHardik Kalra - University of IowaMikhail Vasilyev - University of IowaDavid S Dickens - University of IowaMichael H Tomasson - University of IowaMelissa L Bates - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Comprehensive Physiology, Vol.15(5), e70037
- DOI
- 10.1002/cph4.70037
- PMID
- 40913257
- PMCID
- PMC12413507
- NLM abbreviation
- Compr Physiol
- ISSN
- 2040-4603
- eISSN
- 2040-4603
- Publisher
- Wiley
- Grant note
- American Cancer Society
This work was supported by the National Institute of Health R01CA244271 (Bates and Tomasson) and American Cancer Society RSG-20-017- 01-CCE (Bates and Tomasson). Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UM1TR004403.
- Language
- English
- Date published
- 10/01/2025
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Stead Family Department of Pediatrics; Hematology/Oncology; Health, Sport, and Human Physiology ; Internal Medicine
- Record Identifier
- 9984958609002771
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