title: Blood pressure and body composition in long-term survivors of childhood acute lymphoblastic leukemia.
abstract: BACKGROUND
  Long-term survivors of acute lymphoblastic leukemia (ALL) in childhood are at increased risk of late effects of cancer treatment, among which are cardiovascular sequelae. Purpose of this study was to assess blood pressure and body composition in childhood ALL survivors and compare data to reference values from the general population.
  
  
  METHODS
  This single-center retrospective study included 68 survivors of childhood ALL with a median age of 25 years (range 16.4-39.5) and a median follow-up of 16.0 years (range 5.3-30.4). Data on previous treatment, blood pressure and measurements of weight and height at diagnosis and at long-term follow-up (from which body mass index (BMI) was calculated) were obtained from medical records. All data were converted to control-referenced standard deviation scores.
  
  
  RESULTS
  Of the ALL survivors 48½% were prehypertensive and 22.1% were hypertensive. Both the mean systolic (mean SDS 0.736, P < 0.001) and diastolic blood pressure (mean SDS 0.409, P < 0.001) of survivors was significantly higher compared to reference control values. Based on BMI values, 38.2% of the survivors were considered overweight/obese and females, in contrast to males had a significantly higher BMI (mean SDS 1.355, P < 0.001) compared to reference values. In addition, females who had received cranial radiotherapy (mean SDS 2.078) had a significantly higher BMI than females who had not (mean SDS 0.512) (P = 0.009).
  
  
  CONCLUSIONS
  Both diastolic and systolic blood pressure are significantly increased in survivors of childhood ALL. Female survivors treated with cranial radiation therapy have the highest prevalence and greatest risk of overweight/obesity. Therefore, survivors of childhood ALL are likely to be at an increased risk of cardiovascular disease later in life, which stresses the need for follow-up and adequate medical and/or life style interventions.
authors.affiliation: Department of Pediatric Oncology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Susanna J E
authors.initials: SJ
authors.lastname: Veringa
authors.forename: Eline
authors.initials: E
authors.lastname: van Dulmen-den Broeder
authors.forename: Gertjan J L
authors.initials: GJ
authors.lastname: Kaspers
authors.forename: Margreet A
authors.initials: MA
authors.lastname: Veening
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D001823:Body Composition; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D017741:Survivors; D013997:Time Factors; D055815:Young Adult