Reduced Energy Expenditure in Preobese Children Treated for Acute Lymphoblastic Leukemia

Reilly, John J.; Ventham, J. C.; Ralston, Judith M; Donaldson, M D C; Gibson, Brenda

doi:10.1203/00006450-199810000-00015

Cited by 104 publications

(84 citation statements)

References 21 publications

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“…Several years after cessation of therapy, the resting energy expenditure of survivors is similar to that in controls, 71 or slightly lower. 72 This reduced physical activity, together with altered energy equilibrium, can contribute to obesity.…”

Section: Discussionmentioning

confidence: 99%

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Metabolic syndrome in childhood cancer survivors.

Subramani

Scott

Sneha

et al. 2017

JCO

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145 Background: Reavan in 1988 noted that several risk factors for cardiovascular diseases commonly cluster together, and he recognised them as a disease, named syndrome X, currently known as metabolic syndrome. Metabolic syndrome is a group of disorders related to insulin resistance, characterized clinically by central obesity, hyperglycemia, dyslipidemia and hypertension. There is a growing body of evidence indicating that pediatric cancer survivors are at a greater risk of developing metabolic syndrome. We studied the prevalence of metabolic syndrome in children with cancer who completed their treatment and on follow up. Methods: All relevant past medical data (of the disease, treatment and all events) were collected from the medical records. Tanner staging was perfomred, height was measured using a Harpenden stadiometer. Weight/WAIST circumference were measured. The body mass index (BMI) was calculated as weight (kg)/(height (m)²). BMI ≥90thcentile as per CDC chart was taken as abnormal. Blood pressure was measured on the right arm of the patient. Presence of family history of diabetes, cardiovascular diseases and hypercholesterolemia were taken. Fasting Blood sugar, insulin, HbA1C, lipid profile were done. We used IDF(International diabetes federation) criteria to assess the metabolic syndrome among cancer survivors. This study was approved by our university ethics comittee. Results: Seventy five children who fulfilled the inclusion criteria were included in this study. Out of which 48 were males and 27 were females. Among these, majority of children are treated for acute lymphoblastic leukemia. 8.25% of total population satisfied the criteria of metabolic syndrome. Age, gender, diagnosis, modality of treatment were not to be of statistical significance, however majority of children with metabolic syndrome are in adolescent group. Conclusions: With the better care committed to children with cancer even in developing country, the survival rates are greatly improving and so metabolic syndrome is becoming the major target for intervention in the follow up of cancer survivors. As metabolic syndrome cannot treated by a single drug therapy, it is necessary to have cancer survivors follow up screening.

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Section: Discussionmentioning

confidence: 99%

“…72 Until such a treatment is available, single risk factors should be treated separately. Furthermore, GH deficiency and other endocrinopathies should be investigated and treated.…”

Section: Discussionmentioning

confidence: 99%

Metabolic syndrome in childhood cancer survivors.

Subramani

Scott

Sneha

et al. 2017

JCO

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“…17 In ALL survivors, low physical activity levels begin during the first two decades of life. Child survivors of ALL have lower levels of physical activity than their healthy referents, 8,[23][24][25] leading to worse cardiorespiratory fitness, 7,[26][27][28][29][30][31] physical function, 30 balance and coordination. 32 Identifying the effects of regular physical activity in adult and pediatric survivors of hematological cancer is thus of medical interest.…”

Section: Introductionmentioning

confidence: 99%

Exercise in adult and pediatric hematological cancer survivors: an intervention review

et al. 2010

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Observational research has shown that the physical activity levels of survivors of hematological cancer are low, with deleterious health consequences. This review summarizes the research on exercise interventions in adult and pediatric hematological cancer survivors. We searched MEDLINE, SPORTDiscus, CINAHL, Embase, Cochrane and PEDro through September 2009 for exercise intervention studies in children and adults with any type of hematological cancer. In the 24 adult intervention studies reviewed, we found strong evidence (that is, X3 high-quality studies and X75% reporting a significant benefit) for a benefit on body composition. Weak, but promising, evidence (X3 high-quality studies, but o75% reporting a significant benefit) was found for cardiorespiratory fitness, fatigue, muscle strength, physical functioning and quality of life. In pediatric interventions (13 studies), we found strong evidence for a benefit on muscle strength and cardiorespiratory fitness, particularly, if training was conducted in the hospital setting. Evidence is weak for ankle dorsiflexion, physical functioning and body composition. No exerciserelated risks were identified in adults or children studies. Though more randomized controlled trials are needed, a growing body of literature supports the notion that regular physical activity is safe and has potential benefits for both adult and pediatric hematological cancer survivors.

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“…One major problem in childhood ALL is weight gain during treatment, resulting in obesity [5,11]. Possible underlying mechanisms are treatment with corticosteroids [12], growth hormone deficiency following cranial irradiation [7], and reduced habitual physical activity [10]. Obesity in general is caused by a sustained imbalance between energy intake and energy expenditure.…”

Section: Introductionmentioning

confidence: 99%

Acute lymphoblastic leukemia and obesity: increased energy intake or decreased physical activity?

Jansen

Postma

Stolk

et al. 2008

Support Care Cancer

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Background Obesity is a well-known problem in children with acute lymphoblastic leukemia (ALL), and it might be the result of an excess in energy intake, reduced energy expenditure, or both. The aim of this study is to describe energy intake and physical activity during treatment for ALL with intermittent dexamethasone (DEXA). Methods Body mass index (BMI), energy intake, and physical activity were measured in 16 ALL patients on maintenance treatment and in 17 healthy controls. ALL patients were measured during ("on DEXA") and in between ("off DEXA") DEXA treatments. Results In patients, the mean increase in BMI z-score was 1.4±1.1. Energy intake on DEXA was higher (2,125.9± 476.0 vs 1,775.1±426.1 kcal/24 h, p<0.05) and energy intake off DEXA was lower (1,305.0±249.4 vs 1,775.1± 426.1 kcal/24 h, p<0.05), compared to healthy controls. Physical activity on DEXA was lower compared to healthy controls (30.0±3.9 vs 40.0±6.0 kcal kg −1 24 h −1 , p<0.001and 7,303.1±4,622.9 vs 13,927.2±3,822.7 steps, p<0.05). Physical activity off DEXA was not different compared to healthy controls. Conclusion Weight gain in patients on ALL treatment might be owing to increased energy intake and decreased physical activity during treatment with DEXA.

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Reduced Energy Expenditure in Preobese Children Treated for Acute Lymphoblastic Leukemia

Cited by 104 publications

References 21 publications

Metabolic syndrome in childhood cancer survivors.

Metabolic syndrome in childhood cancer survivors.

Exercise in adult and pediatric hematological cancer survivors: an intervention review

Acute lymphoblastic leukemia and obesity: increased energy intake or decreased physical activity?

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