Publications by authors named "Heleen J H van der Pal"

Background: We assessed the prevalence and diagnostic value of ECG abnormalities for cardiomyopathy surveillance in childhood cancer survivors.

Methods: In this cross-sectional study, 1381 survivors (≥5 years) from the Dutch Childhood Cancer Survivor Study part 2 and 272 siblings underwent a long-term follow-up ECG and echocardiography. We compared ECG abnormality prevalences using the Minnesota Code between survivors and siblings, and within biplane left ventricular ejection fraction (LVEF) categories.

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Article Synopsis
  • - The study examines bone mineral density (BMD) in pediatric survivors of differentiated thyroid carcinoma (DTC) who have undergone thyrotropin-suppressive therapy, focusing on the potential long-term effects of subclinical hyperthyroidism and permanent hypoparathyroidism.
  • - Out of 65 participants, 29% exhibited subclinical hyperthyroidism; while most maintained normal BMD, 13% displayed low BMD after 23.5 years of follow-up, indicating some risk among long-term survivors.
  • - The study found that BMD remained stable over time for both those with and without permanent hypoparathyroidism, as bone turnover markers also showed consistent results throughout the follow-up period.
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Cardiac diseases in the growing population of childhood cancer survivors are of major concern. Cardiotoxicity as a consequence of anthracyclines and chest radiotherapy continues to be relevant in the modern treatment era. Mitoxantrone has emerged as an important treatment-related risk factor and evidence on traditional cardiovascular risk factors in childhood cancer survivors is accumulating.

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Objective: In this report, we determine the cumulative incidence of symptomatic cardiac ischaemia and its risk factors among European 5-year childhood cancer survivors (CCS) participating in the PanCareSurFup study.

Methods: Eight data providers (France, Hungary, Italy (two cohorts), the Netherlands, Slovenia, Switzerland and the UK) participating in PanCareSurFup ascertained and validated symptomatic cardiac events among their 36 205 eligible CCS. Data on symptomatic cardiac ischaemia were graded according to the Criteria for Adverse Events V.

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Objective: To systematically review the literature and assess the diagnostic value of biomarkers in detection of late-onset left ventricular (LV) dysfunction in childhood cancer survivors (CCS) treated with anthracyclines.

Methods: We systematically searched the literature for studies that evaluated the use of biomarkers for detection of LV dysfunction in CCS treated with anthracyclines more than 1 year since childhood cancer diagnosis. LV dysfunction definitions were accepted as an ejection fraction <50% or <55% and/or a fractional shortening <28%, <29% or <30%.

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Objective: The impact of childhood differentiated thyroid carcinoma (DTC) on psychosocial development has not yet been studied. The aim of this study was to evaluate the achievement of psychosocial developmental milestones in long-term survivors of childhood DTC.

Design And Methods: Survivors of childhood DTC diagnosed between 1970 and 2013 were included.

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Article Synopsis
  • The study investigates the long-term quality of life (QoL) of survivors of pediatric differentiated thyroid carcinoma (DTC) by comparing their health outcomes with matched controls.
  • A total of 67 survivors, diagnosed when they were 18 or younger, completed various questionnaires to assess generic health-related QoL, fatigue, anxiety, and depression.
  • While most QoL scores were similar between survivors and controls, survivors reported more physical issues and mental fatigue, indicating some mild impairments in specific QoL areas, with factors like unemployment linked to worse outcomes.
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  • Pediatric differentiated thyroid carcinoma (DTC) treatment relies mainly on adult studies due to limited pediatric data; this study evaluates the presentation, complications, and long-term outcomes in pediatric DTC patients in The Netherlands from 1970 to 2013.
  • The study identified 170 patients, with a 99.4% overall survival rate after a median follow-up of 13.5 years; median age at diagnosis was 15.6 years, and 32.4% experienced life-long postoperative complications.
  • The findings emphasize the need to prioritize reducing treatment-related morbidity and suggest centralizing care to improve outcomes and minimize adverse effects for children with pediatric DTC.
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Survival of childhood cancer has improved resulting in an increasing number of survivors who are at high risk of developing treatment-related health problems. The authors emphasize the need for specialized care for survivors of childhood cancer by describing three patients who all developed late effects of treatment. The first patient, a 32-year-old female, who had several late effects caused by treatment for nephroblastoma; the second a 39-year-old female, who developed breast cancer after thoracic irradiation for metastatic nephroblastoma; the third a 45-year-old female diagnosed with a meningioma caused by cranial irradiation for acute lymphoblastic leukaemia.

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Background: The aim of this study was to investigate the long-term side effects of treatment for childhood Hodgkin's lymphoma with chemotherapy only on growth, bone mineral density (BMD), body composition, and thyroid function.

Procedure: A total of 88 patients (56 male, 32 female; 17.6-42.

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Data on the prevalence of congenital heart defects (CHD) in neuroblastoma patients are inconsistent. If CHD are more common in neuroblastoma patients than in the general population, cardiac screening might be warranted. In this study we used echocardiography to determine the prevalence of CHD in a single centre cohort of surviving neuroblastoma patients.

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Background: To reduce the risk of brain damage children with acute lymphoblastic leukaemia (ALL) are nowadays mainly treated with intrathecal chemotherapy (ITC) instead of central nervous system (CNS) radiation therapy (CRT) to prevent CNS relapse. However, chemotherapy may also lead to cognitive deficits. As growth hormone deficiency (GHD) or impaired growth hormone secretion are frequently found in ALL patients treated with cranial radiation therapy and/or chemotherapy, we hypothesized that GH therapy may reduce cognitive deficits in these patients.

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Asymptomatic anthracycline-induced cardiac damage (A-CD) is a serious problem among young childhood cancer survivors. The aim of this survey was to assess the current treatment policy in these patients in the Netherlands. A questionnaire was sent to all 136 departments of adult or pediatric cardiology in the Netherlands.

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