title: Adverse metabolic and cardiovascular risk following treatment of acute lymphoblastic leukaemia in childhood; two case reports and a literature review.
abstract: We report two patients who survived childhood acute lymphoblastic leukaemia (ALL) following treatment with chemotherapy, total body irradiation (TBI) and bone marrow transplantation (BMT). The first case presented with an acute cerebral infarction at 23 years of age and was found to have non-ketotic diabetes and gross mixed hyperlipidaemia; the second presented with non-ketotic diabetes, hypertension, proteinuria and dyslipidaemia at age 16 years. The association of glucose intolerance with other vascular risk factors in young adult survivors of BMT was recently highlighted in a follow-up study of 23 survivors of BMT [1], but none presented with such gross mixed hyperlipidaemia. The improving survival rates of childhood malignancy over the last two decades will present adult physicians with patients who have accelerated vascular risk at a young age who will require early treatment to modify it.
authors.affiliation: Department of Diabetes, Endocrinology and Clinical Nutrition, University Hospital NHS Trust, Queen's Medical Centre, Nottingham, UK.
authors.forename: P
authors.initials: P
authors.lastname: Amin
authors.forename: S
authors.initials: S
authors.lastname: Shah
authors.forename: D
authors.initials: D
authors.lastname: Walker
authors.forename: S R
authors.initials: SR
authors.lastname: Page
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002318:Cardiovascular Diseases / Q000209:etiology*; D002544:Cerebral Infarction / Q000209:etiology*; D003131:Combined Modality Therapy; D004739:England; D005260:Female; D018149:Glucose Intolerance / Q000209:etiology; D019382:Human Growth Hormone / Q000172:deficiency / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010048:Ovarian Cysts / Q000209:etiology / Q000601:surgery; D010052:Ovariectomy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000628:therapy; D011878:Radiotherapy; D012008:Recurrence; D012307:Risk Factors; D044465:White People
chemical_list: D019382:Human Growth Hormone