No evidence of overweight in long‐term survivors of childhood cancer after glucocorticoid treatment

Belle, Fabiën N.; Kasteler, Rahel; Schindera, Christina; Bochud, Murielle; Ammann, Roland A.; Weid, Nicolas X. von der; Kuehni, Claudia E.

doi:10.1002/cncr.31599

Cited by 11 publications

(13 citation statements)

References 28 publications

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“…Obesity is a well-recognized consequence of childhood ALL therapy among survivors treated with CRT [18, 19]; however, recent publications have highlighted the obesogenic nature of contemporary childhood ALL chemotherapy. In particular, prolonged exposure to corticosteroids has been linked to increased energy intake and weight gain during childhood ALL treatment [14, 20, 21], although the association between corticosteroids and long-term adiposity among survivors is not well-established [5, 22]. Other chemotherapeutic agents may contribute to adverse BMI profiles by adversely impacting energy expenditure by interfering with cardiovascular or motor-sensory function [23, 24].…”

Section: Discussionmentioning

confidence: 99%

Weight trends in a multiethnic cohort of pediatric acute lymphoblastic leukemia survivors: A longitudinal analysis

et al. 2019

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Background As survival rates for childhood acute lymphoblastic leukemia (ALL) continue to improve, there is growing concern over the chronic health conditions that survivors face. Given that survivors of childhood ALL are at increased risk of cardiovascular complications and obesity, we sought to characterize BMI trends from diagnosis through early survivorship in a multi-ethnic, contemporary cohort of childhood ALL patients and determine if early weight change was predictive of long-term weight status. Methods The study population consisted of ALL patients aged 2–15 years at diagnosis who were treated with chemotherapy alone at Texas Children’s Hospital. Each patient had BMI z-scores collected at diagnosis, 30-days post-diagnosis, and annually for five years. Linear regression models were estimated to evaluate the association between: 1) BMI z-score change in the first 30 days and BMI z-scores at five-years post-diagnosis; and 2) BMI z-score change in the first year post-diagnosis and BMI z-scores at five-years post-diagnosis. Results This retrospective cohort study included longitudinal data from 121 eligible patients. The mean BMI z-scores for the population increased significantly (p-value<0.001) from baseline (mean = 0.25) to 30 days post-diagnosis (mean = 1.17) before plateauing after one year post-diagnosis (mean = 0.99). Baseline BMI z-scores were statistically significant predictors to five year BMI z-scores (p <0.001). Independent of baseline BMI z-score and other clinical factors, the BMI z-score at one year post-diagnosis was significantly associated with BMI z-score at five-years post-diagnosis (β = 0.63, p <0.001), while BMI z-score at 30 days post-diagnosis was not (β = 0.10, p = 0.23). Conclusion Our results suggest that weight gain within the first year after diagnosis is more strongly associated with long-term BMI than early weight gain (within 30 days). If confirmed, this information may help identify a window of time during therapy when ALL patients would benefit most from weight management directed interventions.

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Section: Discussionmentioning

confidence: 99%

Weight trends in a multiethnic cohort of pediatric acute lymphoblastic leukemia survivors: A longitudinal analysis

et al. 2019

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“…Steroid use has also been associated with insulin resistance [48] and obesity [49], which are associated with diabetes development in non-cancer populations [50-52]. More recent data from the Swiss Childhood Cancer Study, however, found no evidence of a dose-response relationship between cumulative glucocorticoid dose and overweight in a cohort of 1,936 long-term childhood cancer survivors [53]. Further work is needed to better delineate the relationship between exogenous glucocorticoid use and diabetes risk in childhood cancer survivors.…”

Section: Diabetesmentioning

confidence: 99%

Diabetes and Metabolic Syndrome in Survivors of Childhood Cancer

2019

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Endocrine complications, including diabetes and metabolic syndrome, are highly prevalent in childhood cancer survivors. These metabolic derangements may contribute to survivors’ risk of excess cardiovascular morbidity and premature mortality. This review summarizes existing knowledge on risk of diabetes and metabolic syndrome among childhood cancer survivors, focusing specifically on known risk factors, potential mechanisms, and screening recommendations. Early diagnosis via standardized risk-based screening can improve long-term outcomes in this population. Additional work is needed to elucidate the mechanisms underlying these metabolic complications and to inform the design of risk-reducing interventions and optimize long-term cardiometabolic health among survivors of childhood cancer.

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“…Other treatments were divided into glucocorticoids, anthracyclines, alkylating agents, and hematopoietic stem cell transplantation (HSCT). Glucocorticoid intake, including prednisone and/or dexamethasone, was estimated based on the cancer treatment protocols as described previously [ 37 ]. We also retrieved records on relapse during follow-up.…”

Section: Methodsmentioning

confidence: 99%

Dietary Intake and Diet Quality of Adult Survivors of Childhood Cancer and the General Population: Results from the SCCSS-Nutrition Study

et al. 2021

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Childhood cancer survivors (CCSs) are at increased risk of developing chronic health conditions. This may potentially be reduced by a balanced diet. We aimed to compare dietary intake and diet quality using the Alternative Healthy Eating Index (AHEI) of adult CCSs and the general Swiss population. A food frequency questionnaire (FFQ) was completed by CCSs with a median age of 34 (IQR: 29–40) years. We compared dietary intake of 775 CCSs to two population-based cohorts who completed the same FFQ: 1276 CoLaus and 2529 Bus Santé study participants. CCSs consumed particular inadequate amounts of fiber and excessive amounts of sodium and saturated fat. Dietary intake was similar in CCSs and the general population. The mean AHEI was low with 49.8 in CCSs (men: 47.7, women: 51.9), 52.3 in CoLaus (men: 50.2, women: 54.0), and 53.7 in Bus Santé (men: 51.8, women: 54.4) out of a maximum score of 110. The AHEI scores for fish, fruit, vegetables, and alcohol were worse in CCSs than in the general population, whereas the score for sugar-sweetened beverages was better (all p < 0.001). Diet quality at follow-up did not differ between clinical characteristics of CCSs. Long-term CCSs and the general population have poor dietary intake and quality in Switzerland, which suggests similar population-based interventions for everyone.

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No evidence of overweight in long‐term survivors of childhood cancer after glucocorticoid treatment

Abstract: The results of the current study suggest that glucocorticoids used for the treatment of childhood cancer are not associated with long-term risk of overweight.

Cited by 11 publications

References 28 publications

Weight trends in a multiethnic cohort of pediatric acute lymphoblastic leukemia survivors: A longitudinal analysis

Weight trends in a multiethnic cohort of pediatric acute lymphoblastic leukemia survivors: A longitudinal analysis

Diabetes and Metabolic Syndrome in Survivors of Childhood Cancer

Dietary Intake and Diet Quality of Adult Survivors of Childhood Cancer and the General Population: Results from the SCCSS-Nutrition Study

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