Liver histology after current intensified therapy for childhood acute lymphoblastic leukemia: microvesicular fatty change and siderosis are the main findings

Halonen, Päivi; Mattila, Jouni; Ruuska, Tarja; Salo, Matti K.; Mäkipernaa, Anne

doi:10.1002/mpo.10231

Cited by 26 publications

(19 citation statements)

References 38 publications

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“…[58] Fibrosis developed in 11% and was associated with higher serum LDL-cholesterol. Prospective studies are needed to define whether acute post-therapy fatty liver change contributes to the development of steatohepatitis or the metabolic syndrome in this population.…”

Section: Resultsmentioning

confidence: 99%

Hepato‐biliary late effects in survivors of childhood and adolescent cancer: A report from the Children's Oncology Group

Castellino

Muir

Shah

et al. 2010

Pediatric Blood & Cancer

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Curative therapy for childhood and adolescent cancer translates to 1 in 640 young adults being a survivor of cancer. Although acute hepato‐biliary toxicity occurs commonly during pediatric cancer therapy, the impact of antineoplastic therapy on long‐term liver health in childhood/adolescent cancer survivors is unknown. This article reviews the medical literature on late liver dysfunction following treatment for childhood/adolescent cancer. We also outline the Children's Oncology Group (COG) guidelines for screening and follow‐up of hepato‐biliary sequelae. As the population of survivors grow and age, vigilance for risks to hepatic health needs to continue based on specific exposures during curative cancer therapy. Pediatr Blood Cancer 2010;54:663–669. © 2009 Wiley‐Liss, Inc.

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Section: Resultsmentioning

confidence: 99%

Hepato‐biliary late effects in survivors of childhood and adolescent cancer: A report from the Children's Oncology Group

Castellino

Muir

Shah

et al. 2010

Pediatric Blood & Cancer

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“…Seven participants who received total body irradiation before an allogeneic hematopoietic cell transplant were excluded, as this group has an increased prevalence of fatty liver ( 21 ) and might have an alternate mechanism for development of insulinrelated lipid aberrations. One participant was excluded due to …”

Section: Study Populationmentioning

confidence: 99%

Atherogenic low density lipoprotein phenotype in long-term survivors of childhood acute lymphoblastic leukemia

Malhotra

Tonorezos

Rozenberg

et al. 2012

Journal of Lipid Research

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Supplementary key words cancer • dyslipidemias • lipids • lipoproteins • LDL subfractionsAcute lymphoblastic leukemia (ALL) constitutes more than 80% of newly diagnosed acute leukemias in children and has a current fi ve-year overall survival rate exceeding 85 percent ( 1 ). At the same time, data from the Childhood Cancer Survivor Study (CCSS) suggest that adult survivors of childhood leukemia are at signifi cantly increased risk for myocardial infarction [Hazard rate (HR) 3.3; 95% CI, range 1.2-8.6 ] and congestive heart failure (HR 4.2; 95% CI, range 2.3-7.4) compared with their noncancer siblings ( 2, 3 ). Therefore, it is imperative to identify potential cardiac risk factors in this population at an early stage in the atherosclerotic process.Low-density lipoprotein (LDL) is composed of multiple subfractions based on particle size and density. Among these LDL subfractions, small dense LDL is more atherogenic than larger particles ( 4 ) and is associated with an increased risk for coronary artery disease (CAD) ( 5 ). There are two main subclass patterns of LDL based on predominant LDL particle size: large, buoyant LDL pattern A (particle diameter у 25 nm) and small dense LDL pattern B (particle diameter < 25 nm) ( 6 ). LDL pattern B is independently associated with higher rate of CAD progression

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“…With current ALL therapy histologic changes are smoking increase the risk of pulmonary toxicity. [157] However, the noted in the liver, [168] but if and how this damage will affect an major risk of lung injury relates to therapy. Fortunately, as radiaindividual later in life is unknown.…”

Section: Impact On Cardiac Functionmentioning

confidence: 99%

Surviving Childhood Cancer

2006

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With modern therapies, most children diagnosed with cancer are expected to reach adulthood. Therefore, there are large and ever-increasing numbers of children and young adults in our population who are survivors of childhood cancer. Many of the therapies responsible for improved cancer survival rates can also damage normal cells and tissues. As more children survive cancer, the physical and emotional costs of enduring cancer therapy become increasingly important. Although most childhood cancer survivors are now expected to survive, they remain at risk for relapse, second malignant neoplasms, organ dysfunction, and a negative psychologic impact. Individual risk is quite variable and is dependent on multiple factors including the type and site of cancer, the therapy utilized, and the individual's constitution. The risks are likely to change as we learn more about the specific long-term effects of cancer therapy, develop more refined and targeted therapies, and develop and apply more effective preventative strategies or therapeutic interventions. Guidelines for long-term follow-up have been established and are available to help facilitate appropriate monitoring of and care for potential late effects.

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Liver histology after current intensified therapy for childhood acute lymphoblastic leukemia: microvesicular fatty change and siderosis are the main findings

Abstract: Microvesicular fatty change and siderosis are the main liver findings after current therapy for childhood ALL. Fibrosis occurs rarely. High values in serial serum ALT measurements repeatedly or a disturbed serum lipid profile may facilitate decisions about the need for a liver biopsy.

Cited by 26 publications

References 38 publications

Hepato‐biliary late effects in survivors of childhood and adolescent cancer: A report from the Children's Oncology Group

Hepato‐biliary late effects in survivors of childhood and adolescent cancer: A report from the Children's Oncology Group

Atherogenic low density lipoprotein phenotype in long-term survivors of childhood acute lymphoblastic leukemia

Surviving Childhood Cancer

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