Increased Cardiometabolic Traits in Pediatric Survivors of Acute Lymphoblastic Leukemia Treated with Total Body Irradiation
| Autor: | Debra L. Friedman, K. Scott Baker, Eric J. Chow, Jill H. Simmons, Christian L. Roth, Paul A. Hoffmeister, Jean E. Sanders |
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| Rok vydání: | 2010 |
| Předmět: |
Oncology
Adult Leptin medicine.medical_specialty Adolescent Acute lymphoblastic leukemia Article Cohort Studies Young Adult Risk Factors Internal medicine hemic and lymphatic diseases medicine Humans Prospective Studies Survivors Family history Prospective cohort study Child Childhood Acute Lymphoblastic Leukemia Transplantation Hematopoietic cell transplantation Radiotherapy business.industry Hematopoietic Stem Cell Transplantation Odds ratio Hematology Total body irradiation Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Metabolic syndrome Endocrinology C-Reactive Protein Cross-Sectional Studies Cardiovascular Diseases Insulin Resistance Survivor business Dyslipidemia Whole-Body Irradiation |
| Zdroj: | Biology of Blood and Marrow Transplantation. 16(12):1674-1681 |
| ISSN: | 1083-8791 |
| DOI: | 10.1016/j.bbmt.2010.05.016 |
| Popis: | Survivors of childhood acute lymphoblastic leukemia (ALL) may face an increased risk of metabolic and cardiovascular late effects. To determine the prevalence of and risk factors for adverse cardiometabolic traits in a contemporary cohort of pediatric ALL survivors, we recruited 48 off-therapy patients in remission treated with conventional chemotherapy and 26 treated with total body irradiation (TBI)-based hematopoietic cell transplantation (HCT) in this cross-sectional pilot study. At a median age of 15 years (range, 8-21 years), HCT survivors were significantly more likely than non-HCT survivors to manifest multiple cardiometabolic traits, including central adiposity, hypertension, insulin resistance, and dyslipidemia. Overall, 23.1% of HCT survivors met the criteria for metabolic syndrome (≥ 3 traits), compared with 4.2% of non-HCT survivors (P = .02). HCT survivors also had increased C-reactive protein and leptin levels and decreased adiponectin, suggestive of underlying inflammation and increased visceral fat. In multivariate analyses, history of HCT remained associated with ≥ 2 traits (odds ratio [OR]. 5.13; 95% confidence interval [CI], 1.54-17.15) as well as with ≥ 3 traits (OR, 16.72; 95% CI, 1.66-168.80). Other risk factors included any cranial radiation exposure and family history of cardiometabolic disease. In summary, pediatric ALL survivors exposed to TBI-based HCT as well as to any cranial radiation may manifest cardiometabolic traits at an early age and should be screened accordingly. |
| Databáze: | OpenAIRE |
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