Circulating Endothelial Progenitor Cells and Metabolic Factors in Childhood Cancer Survivors.
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BACKGROUND: Circulating endothelial progenitor cells (cEPCs) are known to have an active role in maintaining healthy vessel anatomy and function. The purpose of the present study was to quantify cEPCs in childhood cancer survivors after treatment completion and evaluate possible associations of their levels with metabolic disorders. METHODS: Circulating EPCs isolated from peripheral blood samples from 383 children and adolescent cancer survivors diagnosed with acute lymphoblastic leukemia (ALL), lymphomas, or solid tumors (ST) were quantified 1, 3, and more than 3 years after treatment completion using flow cytometry. Their levels were compared to 200 healthy controls, and multivariate logistic regression analysis was applied to seek correlations with metabolic disorders, including hypertension, obesity, hyperglycemia, and dyslipidemia. RESULTS: The levels of CD34+/CD133+/VEGFR+ and CD34+/VEGFR+ cEPCs were significantly higher in children treated for solid tumors and lymphomas compared to the ALL group. Compared to controls, both cEPCs populations were found to be increased in patients treated for ST (CD34+/CD133+/VEGFR+, p = 0.0049; CD34+/VEGFR+, p = 0.0001). Declining trends of CD34+/VEGFR+ and CD34+/CD133+/VEGFR+ levels were observed in patients treated for solid tumors and lymphomas during the first 3 years after treatment, while an increasing trend was observed in ALL patients (p = 0.01). Three years after treatment completion, all groups had cEPC levels comparable to the control group. By multivariate regression analysis, no significant differences were observed in children with metabolic disorders, including hypertension, obesity, hyperglycemia, and dyslipidemia. CONCLUSION: Significant differences in cEPC levels were observed in childhood cancer survivors during the first year after treatment completion, which were comparable to healthy controls after 3 years post-treatment.