title: Body composition abnormalities in long-term survivors of pediatric hematopoietic stem cell transplantation.
abstract: OBJECTIVE
  To quantify lean mass (LM) and fat mass (FM) in survivors of childhood allogeneic hematopoietic stem-cell transplantation (alloHSCT) compared with healthy reference participants and identify risk factors for body composition abnormalities.
  
  
  METHODS
  Whole body LM and FM were measured with dual energy x-ray absorptiometry in 54 survivors (ages 5-25 years) and 894 healthy reference participants in a cross-sectional study. Multivariate regression models were used to compare sex- and race-specific Z-scores for LM for height (LM-Ht) and FM for height (FM-Ht) in survivors and reference participants and to identify correlates of LM-Ht and FM-Ht Z-scores in alloHSCT.
  
  
  RESULTS
  Height Z-scores were significantly lower in alloHSCT survivors (P < .001) compared with reference participants; body mass index Z-scores did not differ (P = .13). Survivors had significantly lower mean LM-Ht Z-scores (-0.72; 95% CI, -1.02--0.42; P < .001) and greater FM-Ht Z-scores (1.10; 95% CI, 0.84-1.39; P < .001) compared with reference participants. LM-Ht Z-score deficits in alloHSCT survivors were larger (-1.26; 95% CI, -1.53--0.99; P < .001) after adjustment for FM-Ht Z-scores. Endocrinopathies and alloHSCT characteristics were not associated with LM-Ht or FM-Ht Z-scores.
  
  
  CONCLUSIONS
  Survivors of childhood alloHSCT have significant LM deficits and FM excess. Future studies should identify the mechanism and consequences of these abnormalities.
authors.affiliation: Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. moab@email.chop.edu
authors.forename: Sogol
authors.initials: S
authors.lastname: Mostoufi-Moab
authors.forename: Jill P
authors.initials: JP
authors.lastname: Ginsberg
authors.forename: Nancy
authors.initials: N
authors.lastname: Bunin
authors.forename: Babette S
authors.initials: BS
authors.lastname: Zemel
authors.forename: Justine
authors.initials: J
authors.lastname: Shults
authors.forename: Meena
authors.initials: M
authors.lastname: Thayu
authors.forename: Mary B
authors.initials: MB
authors.lastname: Leonard
mesh_terms: D000273:Adipose Tissue; D000293:Adolescent; D001823:Body Composition; D002648:Child; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data