Sylvester Comprehensive Cancer Center

Tracie L. Miller, M.D.

Tracie L. Miller, M.D.

Professor of Pediatrics

Description of Research

Dr. Miller joined the faculty at the University of Miami in 2003. Dr. Miller has had a number of both NIH grants as well as Foundation awards that study the nutrition, body composition and cardiovascular status (as it relates to atherosclerotic cardiovascular disease risk) in pediatric cancer survivors. Dr. Miller is also studying the effect of a structured physical activity intervention program on metabolic and cardiovascular disease outcomes in pediatric cancer survivors.

Dr. Miller has studied the body composition of pediatric cancer survivors and has determined that survivors, despite having similar BMI’s to their siblings, have greater levels at body fat. This body fat, in turn, was related to receipt of cranial irradiation during their initial treatment as well as their current physical activity level. Furthermore, boys tended to have greater numbers of cardiovascular disease risk factors including higher LDL cholesterols, higher triglycerides and overall total cholesterol. Dr. Miller has also shown that pediatric cancer survivors have decreased exercise capacity as measured by VO2 max testing, when compared to their siblings. Dr. Miller has also assessed bone mineral density of pediatric cancer survivors and has determined that cancer survivors are at risk for low bone mineral density and factors associated with low bone mineral density included low IGF-1 levels and cranial irradiation. Dr. Miller is currently evaluating vascular dysfunction and a physical activity intervention for pediatric cancer survivors and is actively recruiting patients into her studies. In addition, Dr. Miller is a co-investigator on NCI-supported studies that evaluate the role of mitochondrial abnormalities on cardiovascular dysfunction in pediatric cancer survivors.

Highlights

  • Discovery that there are increased levels of body fat in pediatric cancer survivors, despite the body mass index being similar to controls.  Higher levels of body fat are related to cranial irradiation and inactivity.  This suggests that these survivors may be at increased cardiovascular disease risk through their increased levels of body fat.
  • Discovery that male pediatric survivors of childhood cancer have higher levels of lipids that would also place them at a higher cardiovascular disease risk.
  • Discovery that pediatric cancer survivors have lower exercise capacity than sibling controls.  This could also contribute to their greater atherosclerotic cardiovascular disease risk.
  • Discovery that pediatric cancer survivors have lower bone mineral density than expected; and this was also related to cranial irration and hormone levels.

Selected Cancer-Related Publications

  • Landy DC, Lipsitz SR, Kurtz JM, Hinkle AS, Constine LS, Adams MJ, Lipshultz SE, Miller TL. Dietary quality,caloric intake,and adiposity of childhood cancer survivors and their siblings: an analysis from the cardiac risk factors in childhood cancer survivors study. Nutr Cancer 65:547-55,2013 Read more »
  • Lipshultz SE, Lipsitz SR, Kutok JL, Miller TL, Colan SD, Neuberg DS, Stevenson KE, Fleming MD, Sallan SE, Franco VI, Henkel JM, Asselin BL, Athale UH, Clavell LA, Michon B, Laverdiere C, Larsen E, Kelly KM, Silverman LB. Impact of hemochromatosis gene mutations on cardiac status in doxorubicin-treated survivors of childhood high-risk leukemia. Cancer :,2013 Read more »
  • Lipshultz SE, Adams MJ, Colan SD, Constine LS, Herman EH, Hsu DT, Hudson MM, Kremer LC, Landy DC, Miller TL, Oeffinger KC, Rosenthal DN, Sable CA, Sallan SE, Singh GK, Steinberger J, Cochran TR, Wilkinson JD. Long-term Cardiovascular Toxicity in Children,Adolescents,and Young Adults Who Receive Cancer Therapy: Pathophysiology,Course,Monitoring,Management,Prevention,and Research Directions: A Scientific Statement From the American Heart Association. Circulation 128:1927-95,2013 Read more »
  • Lipshultz SE, Landy DC, Lopez-Mitnik G, Lipsitz SR, Hinkle AS, Constine LS, French CA, Rovitelli AM, Proukou C, Adams MJ, Miller TL. Cardiovascular status of childhood cancer survivors exposed and unexposed to cardiotoxic therapy. J Clin Oncol 30:1050-7,2012 Read more »
  • Miller AM, Lopez-Mitnik G, Somarriba G, Lipsitz SR, Hinkle AS, Constine LS, Lipshultz SE, Miller TL. Exercise capacity in long-term survivors of pediatric cancer: An analysis from the cardiac risk factors in childhood cancer survivors study. Pediatr Blood Cancer :,2012 Read more »
  • Lipshultz SE, Miller TL, Lipsitz SR, Neuberg DS, Dahlberg SE, Colan SD, Silverman LB, Henkel JM, Franco VI, Cushman LL, Asselin BL, Clavell LA, Athale U, Michon B, Laverdière C, Schorin MA, Larsen E, Usmani N, Sallan SE. Continuous Versus Bolus Infusion of Doxorubicin in Children With ALL: Long-term Cardiac Outcomes. Pediatrics 130:1003-1011,2012 Read more »
  • Lipshultz SE, Miller TL, Scully RE, Lipsitz SR, Rifai N, Silverman LB, Colan SD, Neuberg DS, Dahlberg SE, Henkel JM, Asselin BL, Athale UH, Clavell LA, Laverdière C, Michon B, Schorin MA, Sallan SE. Changes in cardiac biomarkers during Doxorubicin treatment of pediatric patients with high-risk acute lymphoblastic leukemia: associations with long-term echocardiographic outcomes. J Clin Oncol 30:1042-9,2012 Read more »
  • Landy DC, Miller TL, Lipsitz SR, Lopez-Mitnik G, Hinkle AS, Constine LS, Adams MJ, Lipshultz SE. Cranial Irradiation as an Additional Risk Factor for Anthracycline Cardiotoxicity in Childhood Cancer Survivors: An Analysis from the Cardiac Risk Factors in Childhood Cancer Survivors Study. Pediatr Cardiol :,2012 Read more »
  • Landy DC, Miller TL, Lopez-Mitnik G, Lipsitz SR, Hinkle AS, Constine LS, French CA, Rovitelli AM, Adams MJ, Lipshultz SE. Aggregating traditional cardiovascular disease risk factors to assess the cardiometabolic health of childhood cancer survivors: An analysis from the Cardiac Risk Factors in Childhood Cancer Survivors Study. Am Heart J 163:295-301.e2,2012 Read more »
  • Harake D, Franco VI, Henkel JM, Miller TL, Lipshultz SE. Cardiotoxicity in childhood cancer survivors: strategies for prevention and management. Future Cardiol 8:647-70,2012 Read more »
  • Jean-Pierre P, Winters PC, Ahles TA, Antoni M, Armstrong FD, Penedo F, Lipshultz SE, Miller TL, Fiscella K. Prevalence of self-reported memory problems in adult cancer survivors: a national cross-sectional study. J Oncol Pract 8:30-4,2012 Read more »
  • Franco VI, Henkel JM, Miller TL, Lipshultz SE. Cardiovascular effects in childhood cancer survivors treated with anthracyclines. Cardiol Res Pract 2011:134679,2011 Read more »
  • Trachtenberg BH, Landy DC, Franco VI, Henkel JM, Pearson EJ, Miller TL, Lipshultz SE. Anthracycline-associated cardiotoxicity in survivors of childhood cancer. Pediatr Cardiol 32:342-53,2011 Read more »
  • Miller TL, Lipsitz SR, Lopez-Mitnik G, Hinkle AS, Constine LS, Adams MJ, French C, Proukou C, Rovitelli A, Lipshultz SE. Characteristics and determinants of adiposity in pediatric cancer survivors. Cancer Epidemiol Biomarkers Prev 19:2013-22,2010 Read more »
  • Lipshultz SE, Scully RE, Lipsitz SR, Sallan SE, Silverman LB, Miller TL, Barry EV, Asselin BL, Athale U, Clavell LA, Larsen E, Moghrabi A, Samson Y, Michon B, Schorin MA, Cohen HJ, Neuberg DS, Orav EJ, Colan SD. Assessment of dexrazoxane as a cardioprotectant in doxorubicin-treated children with high-risk acute lymphoblastic leukaemia: long-term follow-up of a prospective,randomised,multicentre trial. Lancet Oncol 11:950-61,2010 [JIF 14.470] Read more »

Programs

Collaborating in the Multidisciplinary Research Program(s):

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