Cardiovascular Status of Patients after Chemotherapy for Haematological Cancers in Jos Nigeria Okeahialam BN 1* , Muoneme SA 1 and Egesie OJ 2 1 Departments of Medicine, Jos University Teaching Hospital, Jos, Nigeria 2 Departments of Haematology, Jos University Teaching Hospital, Jos, Nigeria * Corresponding author: B. N. Okeahialam, Department of Medicine Jos University Teaching Hospital, Jos, Nigeria, Tel : +2348051499271; E-mail: baskeam@yahoo.com Received date: November 07, 2016, Accepted date: December 08, 2016, Published date: February 22, 2017 Copyright: © 2017 Okeahialam BN, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Heart disease can result from cancers and their treatment, heart failure being the case over time. This is however not our local experience as hardly we find heart failure patients with a past history of cancer or chemotherapy. We therefore decided to evaluate a cohort of patients on follow-up for haematological cancer therapy for cardiovascular status with a view to defining their heart disease burden. Thirteen patients (6 F) with age range of 18 to 55 years on follow-up for haematological cancers underwent cardiovascular examination and relevant data extracted from their files. None of them was in heart failure after a range of 1 to 3 years of therapy. Most however received Prednisolone as adjunctive treatment for their cancers namely: CLL, CML, ALL, AML and Hodgkin’s Lymphoma. The low rate of heart disease in our cohort of haematological cancers was surprising. Whether it is due to genetics, environmental factor or adjunctive treatment would require further studies to elucidate. Steroids being anti-inflammatory and anti- fibrotic may be countering inflammatory and fibrotic cardiac damage that chemotherapeutic agents cause. Keywords: Heart disease; Cancers; Drugs; Nigeria Introduction Te risk of malignancy is known to rise as the population ages [1]. Tough not common place, some of the cancers can involve the heart [2]; as in hepato-cellular carcinoma [3]. Cancers can directly damage the heart before any treatment [4]; but it is the therapy (chemo and radio) that is more deleterious to cardiac function [5]. As more people survive cancer treatment, a pool of people with cardiovascular morbidity is developed; that will strain the health care system. Tis has given rise to a new feld of integrative medicine (Cardio-Oncology/ Onco-Cardiology) between cardiologists and oncologists to manage such cases [6]. Cardiac toxicity follows use of many chemotherapeutic agents, the anthracycline group being the chief culprit; though others like cyclophospahmide and fuorouracil are implicated [7]. It has been a recognized entity for about 50 years following reports of heart failure in children treated with doxorubicin [8]. Cardiotoxic efects of chemotherapy range from mild transient blood pressure elevation and electrocardiographic perturbations to signifcant arrhythmias, myocarditis, pericarditis, myocardial infarction and cardiomyopathy [7]. In our experience, not many patients presenting with heart failure (HF) give a past history of cancer treatment. With the established fact that systemic cancer treatment exerts a detrimental efect on the cardiovascular system [9], our local experience became a matter of curiosity. We, therefore, decided to clinically assess the cardiovascular status of oncology patients who are on follow-up in the Haematology out-patient clinic of our hospital. Tis was to ascertain their cardiovascular disease burden; and if possible why heart failure following cancer treatment is a rarity in our experience. Methods Between October and December 2011, all subjects on follow-up in the Haematology Clinic of Jos University Teaching Hospital afer chemotherapy for haematological cancers were assessed clinically; and relevant information extracted from their records. Tis was with their full consent and included: age, gender, age at frst dose, number of doses till date, date of last dose, cumulative dose, drug(s) used, route of administration, medical history before therapy, current medical therapy, diagnosis of malignancy, any other treatment modality and history of shortness of breath. Physical examination recorded pulse, blood pressure, apex beat, heart sounds, postero-basal crepitations, ascites and hepatomegaly. Any chest X-ray, electrocardiogram and packed cell volume reports found were documented. Results Only 13 patients were on follow-up for cancer therapy on the Haematology service at the time; 6 of whom were females. Teir ages ranged from 18 to 55 years. Most (11/18) were in their frst year of treatment. Te remaining 2 were 2 years and 3 years into treatment. Number of doses ranged from 1 to 8 and last dose from the point of encounter varied from 1 to 88 weeks. Drugs used included Alkylating agents – Cyclophosphamide, Chlorambucil and Decarbazine; Vinca Alkaloids – Vincristine and Vinblastine; Anti-metabolites – Cytosine Arabinoside, Hydroxyurea, Methotrexate; Anthracycline – Adriamycin; Antibiotic – Bleomycin. Route of administration was mostly parenteral (intra-venous) See Table 1. Prior to chemotherapy, 2 patients had hypertension only, 1 in addition to hypertension had diabetes mellitus and prostatism. Okeahialam et al, J Cancer Clin Trials 2017, 2:1 Research Article Open Access J Cancer Clin Trials, an open access journal Volume 2 • Issue 1 • 1000127 Journal of Cancer Clinical Trials J o u r n a l o f C a n c e r C l i n i c a l T r i a l s