Blood pressure and body composition in long‐term survivors of childhood acute lymphoblastic leukemia

Veringa, Susanna J.E.; Broeder, Eline van Dulmen‐den; Kaspers, Gertjan J. L.; Veening, Margreet A.

doi:10.1002/pbc.23251

Cited by 62 publications

(71 citation statements)

References 38 publications

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“…Veringa et al 24 , em estudo retrospectivo incluindo 68 pacientes sobreviventes de LLA, encontraram 38,8% de excesso de peso, enquanto Chow et al 25 , em estudo longitudinal incluindo 165 sobreviventes de LLA, obtiveram 38,2%. A última pesquisa brasileira de base populacional (Pesquisa de Orçamentos Familiares -POF 2008/2009) 26 realizada pelo Instituto Brasileiro de Geografia e Estatística (IBGE) obteve frequências para excesso de peso de 33,5% entre as crianças (5 a 9 anos) e de 21,5% entre os adolescentes (10 e 19 anos).…”

Section: I S C U S S ã Ounclassified

Estado nutricional de crianças e adolescentes sobreviventes de leucemia linfoide aguda tratados em um Centro de Referência da Região Nordeste do Brasil

et al. 2013

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OBJETIVO: Avaliar o estado nutricional e os fatores clínicos, laboratoriais e comportamentais associados ao excesso de peso em crianças e adolescentes sobreviventes de leucemia linfoide aguda, tratados em um centro de referência da Região Nordeste do Brasil. MÉTODOS: Estudo de série de casos com 30 sobreviventes de leucemia linfoide aguda. Entre os meses de março e setembro de 2011, foram coletados dados clínicos, comportamentais e laboratoriais. O diagnóstico antropométrico foi realizado em três ocasiões distintas: no momento do diagnóstico, no término do tratamento, e no período pós-tratamento, a partir dos índices altura/idade e índice de massa corporal/idade, segundo a Organização Mundial de Saúde. RESULTADOS: A amostra tinha idade média de 10,2 anos (DP=3,2). Observou-se que 33,3% dos sobreviventes tinham excesso de peso no início e no término do tratamento. No período pós-tratamento, encontrou-se aumento significante do escore-Z de índice de massa corporal/idade, e uma frequência de 43,3% de excesso de peso, além de 16,6% e 35,5% de obesidade abdominal por meio da circunferência da cintura e razão cintura/estatura respectivamente. O crescimento linear foi significativamente diminuído quando comparado os escores-Z de altura/idade no início e no término do tratamento. Na análise dos dados laboratoriais, obtiveram-se 52,1% com colesterol total acima do recomendado. Entretanto, 58,3%, 66,7% e 79,2% evidenciaram, respectivamente, Lipoproteína de Alta Densidade e Lipoproteína de Baixa Densidade-colesterol e triglicerídeo na faixa considerada desejável. CONCLUSÃO: Os sobreviventes de leucemia linfoide aguda analisados apresentaram maior risco para o desenvolvimento de doenças crônicas não transmissíveis uma vez que apresentam frequência importante de excesso de peso, obesidade abdominal e colesterol total elevado.

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Estado nutricional de crianças e adolescentes sobreviventes de leucemia linfoide aguda tratados em um Centro de Referência da Região Nordeste do Brasil

et al. 2013

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“…In several studies concerning acute lymphoblastic leukemia survivors, no significant difference in blood pressure between irradiated and non-irradiated patients has been described. 44 reported higher systolic blood pressure values among nonirradiated patients, albeit without performing a statistical analysis of the difference. 42 Finally, one study has shown that blood pressure was significantly higher in non-irradiated patients, which is consistent with our results.…”

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confidence: 99%

Metabolic syndrome in long-term survivors of childhood acute leukemia treated without hematopoietic stem cell transplantation: an L.E.A. study

et al. 2016

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C ardiovascular conditions are serious long-term complications of childhood acute leukemia. However, few studies have investigated the risk of metabolic syndrome, a known predictor of cardiovascular disease, in patients treated without hematopoietic stem cell transplantation. We describe the overall and age-specific prevalence, and the risk factors for metabolic syndrome and its components in the L.E.A. (Leucémie de l'Enfant et de l'Adolescent) French cohort of childhood acute leukemia survivors treated without hematopoietic stem cell transplantation. The study included 650 adult patients (mean age at evaluation: 24.2 years; mean follow-up after leukemia diagnosis: 16.0 years). The prevalence of metabolic syndrome was 6.9% (95% CI 5.1-9.2). The age-specific cumulative prevalence at 20, 25, 30 and 35 years of age was 1.3%, 6.1%, 10.8% and 22.4%, respectively. The prevalence of decreased high-density lipoprotein cholesterol, increased triglycerides, increased fasting glucose, increased blood pressure and increased abdominal circumference was 26.8%, 11.7%, 5.8%, 36.7% and 16.7%, respectively. Risk factors significantly associated with metabolic syndrome in the multivariate analysis were male sex (OR 2.64; 95% CI 1.32-5.29), age at last evaluation (OR 1.10; 95% CI 1.04-1.17) and body mass index at diagnosis (OR 1.15; 95% CI 1.01-1.32). The cumulative steroid dose was not a significant risk factor. Irradiated and non-irradiated patients exhibited different patterns of metabolic abnormalities, with more frequent abdominal obesity in irradiated patients and more frequent hypertension in non-irradiated patients. Survivors of childhood acute leukemia are at risk of metabolic syndrome, even when treated without hematopoietic stem cell transplantation or central nervous system irradiation. A preventive approach with regular screening for cardiovascular risk factors is recommended.

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“…[9][10][11] With the decreasing use of CRT by cooperative groups, it remains unclear whether intrathecal and systemic chemotherapy alone are associated with obesity in pediatric ALL survivors. Female gender and a young age at diagnosis were predictors for obesity in some [10][11][12][13][14] but not all studies. 7,9,12,15,16 The rate of obesity may also vary by interval from cancer diagnosis.…”

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confidence: 99%

Obesity in Pediatric ALL Survivors: A Meta-Analysis

et al. 2014

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Obesity in Pediatric ALL Survivors: A Meta-Analysis abstract BACKGROUND AND OBJECTIVE: Previous studies of survivors of pediatric acute lymphoblastic leukemia (ALL) have drawn heterogeneous conclusions regarding the prevalence of obesity and risk factors for developing obesity in pediatric ALL survivors. We sought to determine the prevalence of obesity in pediatric ALL survivors and examine risk factors for obesity through a systematic review and meta-analysis. METHODS:A MEDLINE search was performed from its inception through 2013. Studies met the inclusion criteria if they (1) included at least 10 survivors of pediatric ALL; (2) assessed the prevalence or indicators of obesity; and (3) compared obesity among ALL survivors to a reference population or external control group. Extracted data included patient and treatment characteristics, study design, population used for comparison, and prevalence of obesity. RESULTS:Forty-seven studies met the inclusion criteria. Despite significant heterogeneity among the studies (I 2 = 96%), the mean BMI z score in 1742 pediatric ALL survivors was 0.83 (95% confidence interval: 0.60-1.06), which corresponds to the 80th BMI percentile, indicating a significantly higher BMI in pediatric ALL survivors than the reference population. Subgroup analyses found a high prevalence of obesity in ALL survivors regardless of survivors' receipt of cranial irradiation, gender, or age at diagnosis. CONCLUSIONS:Obesity is prevalent in pediatric ALL survivors and is independent of patient-and treatment-related characteristics. Clinicians need to screen for obesity and its associated health conditions early in survivorship. Pediatrics 2014;133:e704-e715

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Blood pressure and body composition in long‐term survivors of childhood acute lymphoblastic leukemia

Cited by 62 publications

References 38 publications

Estado nutricional de crianças e adolescentes sobreviventes de leucemia linfoide aguda tratados em um Centro de Referência da Região Nordeste do Brasil

Estado nutricional de crianças e adolescentes sobreviventes de leucemia linfoide aguda tratados em um Centro de Referência da Região Nordeste do Brasil

Metabolic syndrome in long-term survivors of childhood acute leukemia treated without hematopoietic stem cell transplantation: an L.E.A. study

Obesity in Pediatric ALL Survivors: A Meta-Analysis

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