Leiden University Scholarly Publications

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Willemse, P.P.M. (2014)

Skeletal and metabolic complications of testicular germ cell tumours.

Doctoral Thesis
The studies described in this thesis were performed to investigate the short and long-term effects of chemotherapy on bone metabolism, fat metabolism and cardiovascular risk in testicular germ cell tumour (GCT) patients. We report a twofold increased prevalence of Metabolic Syndrome (MetS) in GCT patients who received chemotherapy compared to that in patients with stage 1 disease who did not receive chemotherapy, or to that in healthy controls. Thereafter, we describe disadvantageous metabolic changes and acute alterations in diastolic heart function in GCT patients treated with cisplatin-based chemotherapy. In the same group of patients we show that, during chemotherapy administrations, serum non-protein bound iron concentrations were inversely related to the latent iron-binding capacity and serum iron concentrations. This suggests that chemotherapy-associated iron overload may play a role in short and long-term chemotherapy induced toxicity in GCT patients. The study on bone...Show moreThe studies described in this thesis were performed to investigate the short and long-term effects of chemotherapy on bone metabolism, fat metabolism and cardiovascular risk in testicular germ cell tumour (GCT) patients. We report a twofold increased prevalence of Metabolic Syndrome (MetS) in GCT patients who received chemotherapy compared to that in patients with stage 1 disease who did not receive chemotherapy, or to that in healthy controls. Thereafter, we describe disadvantageous metabolic changes and acute alterations in diastolic heart function in GCT patients treated with cisplatin-based chemotherapy. In the same group of patients we show that, during chemotherapy administrations, serum non-protein bound iron concentrations were inversely related to the latent iron-binding capacity and serum iron concentrations. This suggests that chemotherapy-associated iron overload may play a role in short and long-term chemotherapy induced toxicity in GCT patients. The study on bone metabolism shows an increased prevalence of vertebral fractures, independent of BMD and anticancer treatment, in newly diagnosed as well as long term survivors of testicular cancer. The last chapter reports on a significant decline in lumbar and femoral BMD in metastatic GCT patients one year after chemotherapeutic treatment.Show less
Germ cell tumoer
Chemotherapy
Osteoporosis
Vertebral fracture
Non-protein bound iron
Proton magnetic resonance spectroscopy
Ventricular dysfunction
Hepatic triglyceride content
Cardiovascular disease
Metabolic syndrome
All authors
Willemse, P.P.M.
Supervisor
Osanto, S.; Burggraaf, J.
Co-supervisor
Hamdy, N.A.T.
Qualification
Doctor (dr.)
Awarding Institution
Faculty of Medicine (LUMC), Leiden University
Date
2014-03-06
ISBN (print)
9789053358047

Funding

Sponsorship
The publication of this thesis was supported by: the Department of Clinical Oncology of the LUMC, Abbvie B.V., Amgen B.V., Astellas B.V., GlaxoSmithKline, Janssen-Cilag B.V. and Pfizer B.V.