Body composition of long‐term survivors of acute lymphoblastic leukaemia†

Warner, Justin; Evans, W. D.; Webb, David; Gregory, John Welbourn

doi:10.1002/mpo.1304

Cited by 76 publications

(75 citation statements)

References 33 publications

(41 reference statements)

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“…These survivors had completed treatment within 10 years at the time of study evaluation. 8,12,13,16,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] Only 2 studies 14,40 examined BMI z score assessed $10 years after the completion of treatment (ie, off treatment $10 years). Because neither study reported SD/SE of the BMI z score, the meta-analysis did not include survivors who were off treatment beyond 10 years.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%

Obesity in Pediatric ALL Survivors: A Meta-Analysis

et al. 2014

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“…These findings are difficult to explain and are contradictory to those of van de Sluis et al (29), who found no difference in total body fat mass in patients who had not received CRT compared with controls 9.6 years after treatment. The majority of previous reports have studied cranially irradiated patients who have been found to have increased total body fat mass (30,31).…”

Section: Discussionmentioning

confidence: 99%

Body composition in young adult survivors of childhood acute lymphoblastic leukaemia

Jarfelt¹,

Lannering²,

Bosæus³

et al. 2005

eur j endocrinol

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Objective: Obesity is frequently reported in patients treated for childhood leukaemia. Obesity, particularly abdominal obesity, is one of the main characteristics of the metabolic syndrome and a risk factor for cardiovascular disease and non-insulin-dependent diabetes mellitus (NIDDM). Design: All patients treated for acute lymphoblastic leukaemia (ALL) before the onset of puberty in the region of western Sweden, between 1973 and, and in first remission, were included. 35 out of 47 patients aged 20-32 years participated. 19 patients had received cranial radiotherapy, and the median follow-up time was 20 years. The focus of this report was to study body composition and signs of the metabolic syndrome and correlate the findings to spontaneous growth hormone (GH) secretion. Methods: Body composition was assessed using dual-energy X-ray absorbtiometry (DEXA). We analyzed serum concentrations of insulin, glucose, leptin and lipids. Results: No patient was obese according to World Health Organization criteria (body mass index, BMI $ 30 kg/m 2 ) but one-third were overweight (BMI 25-29.9 kg/m 2 ). The maximal GH peak during 24 h (GH max ) was correlated to percentage of total body fat (r ¼ 2 0.42; P ¼ 0.017), trunk fat (r ¼ 2 0.5; P ¼ 0.005) and fat-free mass (r ¼ 0.42; P ¼ 0.017). GH max was also correlated to s-triglycerides (r ¼ 2 0.54; P ¼ 0.001), low-density lipoprotein-cholesterol (r ¼ 2 0.382; P ¼ 0.024) and high-density lipoprotein-cholesterol (r ¼ 0.45; P ¼ 0.007). Conclusions: We found little effect on BMI but an increased percentage of total body fat, especially trunk fat, and a tendency for an unfavourable lipid profile in adult survivors of childhood leukaemia. These findings were related to low endogenous GH secretion due to cranial irradiation. European Journal of Endocrinology 153 81-89

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“…Body mass index (BMI) has been found to be significantly higher in female survivors when compared to both the expected norms, and control subjects. 29 Females treated with high dose cranial irradiation (20 -24Gy), at a young age were found to have a 55% chance of being overweight or obese in the future. 30 Male survivors also demonstrated higher BMIs indicating weight problems.…”

Section: -26mentioning

confidence: 99%

“…However, male control subjects also displayed signs of being overweight. 29 Therefore, the effect of cancer treatment on male survivors' body composition is not clear. In terms of bone mineral density (BMD), there were no differences between cases and controls, except regarding lumbar spine bone density, which was significantly lower in survivors.…”

Section: -26mentioning

confidence: 99%

What are the long-term effects of treatment on survivors of childhood leukaemia? A review of the literature

Whitaker

2013

J Radiother Pract

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Key advances in cancer treatment have led to an increasing number of long-term cancer survivors. Knowledge of the long-term effects of cancer treatment of leukaemia survivors is to some degree limited. This article investigates the effects of the treatment of childhood leukaemia on the quality of life, physical and psychological wellbeing and general development of survivors. This article reviews current literature to examine existing gaps in knowledge and identify a potential focus of future research and clinical practice.

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Body composition of long‐term survivors of acute lymphoblastic leukaemia†

Cited by 76 publications

References 33 publications

Obesity in Pediatric ALL Survivors: A Meta-Analysis

Obesity in Pediatric ALL Survivors: A Meta-Analysis

Body composition in young adult survivors of childhood acute lymphoblastic leukaemia

What are the long-term effects of treatment on survivors of childhood leukaemia? A review of the literature

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