Impaired glucose tolerance and dyslipidaemia as late effects after bone-marrow transplantation in childhood

Taskinen, M.; Saarinen‐Pihkala, Ulla M.; Hovi, Liisa; Lipsanen-Nyman, Mania

doi:10.1016/s0140-6736(00)02717-3

Cited by 263 publications

(249 citation statements)

References 17 publications

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“…All patients had normal fasting blood glucose and HbA 1 c levels, whereas insulin levels, the insulinaemia : glycaemia ratio and the firstphase insulin response were significantly higher in patients than in control subjects, particularly in those who underwent TBI. Our data suggest that children given TBI may develop a state of insulin resistance, as more recently reported by Taskinen et al [4], who found a high risk of insulin resistance in patients who underwent TBI before BMT in childhood. Moreover, in personnel who took part in the cleaning-up operation after the Chernobyl nuclear incident, hyperinsulinaemia was observed and was interpreted to be a direct or indirect consequence of irradiation [5].…”

supporting

confidence: 88%

Comment to: Zalutskaya A, Bornstein SR, Mokhort T, Garmaev D (2004) Did the Chernobyl incident cause an increase in type 1 diabetes mellitus incidence in children and adolescents? Diabetologia 47:147–148 (Letter)

Lorini

d’Annunzio

2005

Diabetologia

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supporting

confidence: 88%

Comment to: Zalutskaya A, Bornstein SR, Mokhort T, Garmaev D (2004) Did the Chernobyl incident cause an increase in type 1 diabetes mellitus incidence in children and adolescents? Diabetologia 47:147–148 (Letter)

Lorini

d’Annunzio

2005

Diabetologia

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“…However, metabolic (4) and cardiovascular morbidity (5), as newer entities in the field, may deserve more emphasis with elapsing time after transplantation. We observed insulin resistance, impaired glucose tolerance, and dyslipidemia in a time-correlated manner in one-third of the young adults studied 3-18 y after HSCT in childhood (4). Metabolic abnormalities have also been reported in adult female recipients of stem cell transplantation (6).…”

mentioning

confidence: 54%

“…The core signs of metabolic syndrome-hypertriglyceridemia, hyperinsulinemia, and abdominal obesity-have been observed in one-third of the young long-term survivors after allogeneic HSCT (4,24). Metabolic syndrome characterizes, at least when left untreated, a process from single disturbances in lipid and glucose metabolism to hypertension, type 2 diabetes, and severe cardiovascular disease (25).…”

Section: Discussionmentioning

confidence: 99%

Time-related arterial changes after allogeneic hematopoietic stem cell transplantation in children

et al. 2013

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Background: Metabolic syndrome is a frequent late effect in young adults after hematopoietic stem cell transplantation (HSCT) performed in childhood. Methods: To further study the signs of cardiovascular changes in HSCT patients, we performed noninvasive vascular ultrasonic measurements of arterial stiffness and endothelial function in 25 children (median age: 11.2 y) and in 22 healthy matched controls. results: The distensibility of the common carotid artery (CCA) was significantly lower in the patients than in the controls (mean = 0.48, SD = 0.19 vs. mean = 0.64 mm Hg −1 × 10 −2 , SD = 0.28; P = 0.024). The distensibility decreased with time passed after HSCT (P = 0.009). The compliance of the CCA was decreased (mean = 0.10, SD = 0.04 vs. mean = 0.13 mm 2 × mm Hg −1 , SD = 0.05; P = 0.041), and the incremental elastic modulus (E inc) was higher in the patients than in the controls (mean = 2.05, SD = 0.7 vs. mean = 1.6 mm × 10 3 , SD = 0.6; P = 0.019). E inc was associated with time passed after HSCT (P = 0.036). The size of the brachial artery and flow-mediated dilation did not differ between the groups. conclusion: Early mechanical changes of the arterial wall were found at young age after HSCT. Ultrasonography may offer a noninvasive method to find early alterations of the vascular bed and to optimize prevention of atherosclerosis in HSCT patients.

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“…Impaired glucose tolerance and insulin resistance have been reported in adult survivors of ALL and AML after SCT with TBI, 17 as well as in survivors of childhood cancers treated with SCT. 18,19 Additionally, increased prevalence of DM has been reported in cancer survivors who were treated with SCT. [20][21][22] Lorini et al 20 found that insulin resistance develops in those treated with radiation, but mostly after TBI, while Hoffmeister et al 21 did not find TBI as a significant risk factor.…”

Section: Discussionmentioning

confidence: 99%

Late effects in children treated with intensive multimodal therapy for high-risk neuroblastoma: High incidence of endocrine and growth problems

Cohen

Gordon

Popovsky

et al. 2014

Bone Marrow Transplant

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Due to the poor prognosis of high-risk (HR) neuroblastoma (NBL), scant data exist on late effects after treatment. Recently, protocols utilizing intense multimodal treatment have resulted in improved long-term survival. The objective of this study was to determine the prevalence of late effects in survivors of HR NBL. A retrospective review of clinical data for serial patients completing treatment between September 1994 and October 2007 and surviving for at least 1 year was performed. Therapy included aggressive chemotherapy, surgery, radiation and single or tandem SCT. Oncology follow-up was standard; clinical criteria were utilized for referrals to endocrinology and other services. Fifty-one eligible patients were identified. Median follow-up was 6.1 years (range 1.0-15.2). Height was significantly impacted (DZ-score À 1.91 in those treated with TBI and À 0.77 in those without). Pre-diabetes or diabetes, hypothyroidism and ovarian insufficiency were observed in 50, 59 and 75% of at-risk survivors, respectively. Hearing loss and dental issues were common. Nine patients had relapse of NBL; seven died of progressive disease. As there is a high prevalence of late effects in long-term survivors of HR NBL, close monitoring and further studies after treatment are indicated, and in particular after more modern, non-TBI regimens.

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Impaired glucose tolerance and dyslipidaemia as late effects after bone-marrow transplantation in childhood

Cited by 263 publications

References 17 publications

Comment to: Zalutskaya A, Bornstein SR, Mokhort T, Garmaev D (2004) Did the Chernobyl incident cause an increase in type 1 diabetes mellitus incidence in children and adolescents? Diabetologia 47:147–148 (Letter)

Comment to: Zalutskaya A, Bornstein SR, Mokhort T, Garmaev D (2004) Did the Chernobyl incident cause an increase in type 1 diabetes mellitus incidence in children and adolescents? Diabetologia 47:147–148 (Letter)

Time-related arterial changes after allogeneic hematopoietic stem cell transplantation in children

Late effects in children treated with intensive multimodal therapy for high-risk neuroblastoma: High incidence of endocrine and growth problems

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