title: Metabolic syndrome in adults who received hematopoietic stem cell transplantation for acute childhood leukemia: an LEA study.
abstract: We evaluated prospectively the incidence and risk factors of the metabolic syndrome (MS) and its components in 170 adult patients (mean age at evaluation: 24.8±5.4 years) who received an hematopoietic stem cell transplantation for childhood ALL, n=119, or AML, n=51. TBI was carried out in 124 cases; a busulfan-based conditioning was done in 30 patients. Twenty-nine patients developed a MS (17.1%, 95% confidence intervals: 11.7-23.6). The cumulative incidence was 13.4% at 25 years of age and 35.5% at 35 years of age. A higher body mass index (BMI) before transplantation and a growth hormone deficiency were associated with increased MS risk (P=0.002 and 0.01, respectively). MS risk was similar for patients who received TBI or busulfan-based conditioning. The TBI use increased the hyperglycemia risk (odds ratio (OR): 4.7, P=0.02). Women were at the risk of developing increased waist circumference (OR: 7.18, P=0.003) and low levels of high-density lipoprotein cholesterol (OR: 2.72, P=0.007). The steroid dose was not a risk factor. The MS occurs frequently among transplanted survivors of childhood leukemia. Its incidence increases with age. Both intrinsic (BMI, gender) and extrinsic factors (TBI, alkylating agents) contribute to its etiopathogenesis.
authors.affiliation: Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France.|Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Oudin
authors.affiliation: Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, Marseille, France.
authors.forename: P
authors.initials: P
authors.lastname: Auquier
authors.affiliation: Department of Pediatric Hematology and Oncology, University Hospital of Lyon, Lyon, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Bertrand
authors.affiliation: Department of Pediatric Onco-Haematology, Hôpital d'Enfants de Brabois, Vandoeuvre Les Nancy, France.
authors.forename: A
authors.initials: A
authors.lastname: Contet
authors.affiliation: Department of Pediatric Hematology and Oncology, CIC Inserm 501, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: J
authors.initials: J
authors.lastname: Kanold
authors.affiliation: Departmnent of Pediatric Hematology and Oncology, University Hospital, Montpellier, France.
authors.forename: N
authors.initials: N
authors.lastname: Sirvent
authors.affiliation: Pediatric Hematology, University Hospital, Saint Etienne, France.
authors.forename: S
authors.initials: S
authors.lastname: Thouvenin
authors.affiliation: Departmnent of Pediatric Hematology, Trousseau Hospital, Paris, France.
authors.forename: M-D
authors.initials: MD
authors.lastname: Tabone
authors.affiliation: Department of Pediatric Hematology and Oncology, Hospital University, Strasbourg, France.
authors.forename: P
authors.initials: P
authors.lastname: Lutz
authors.affiliation: Department of Pediatric Hematology and Oncology, University Hospital of Bordeaux, Bordeaux, France.
authors.forename: S
authors.initials: S
authors.lastname: Ducassou
authors.affiliation: Department of Pediatric Hematology and Oncology, University Hospital of Grenoble, Grenoble, France.
authors.forename: D
authors.initials: D
authors.lastname: Plantaz
authors.affiliation: Departmnent of Pediatric Hematology, Robert Debré Hospital, Paris, France.
authors.forename: J-H
authors.initials: JH
authors.lastname: Dalle
authors.affiliation: Department of Pediatric Hematology and Oncology, University Hospital of Rennes, Rennes, France.
authors.forename: V
authors.initials: V
authors.lastname: Gandemer
authors.affiliation: Department of Endocrinology and Nutrition, Timone Hospital Marseille, Marseille, France.
authors.forename: S
authors.initials: S
authors.lastname: Beliard
authors.affiliation: Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, Marseille, France.
authors.forename: J
authors.initials: J
authors.lastname: Berbis
authors.affiliation: Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Vercasson
authors.affiliation: Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France.|Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, Marseille, France.
authors.forename: V
authors.initials: V
authors.lastname: Barlogis
authors.affiliation: Departmnent of Pediatric Hematology, Robert Debré Hospital, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Baruchel
authors.affiliation: Departmnent of Pediatric Hematology, Trousseau Hospital, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Leverger
authors.affiliation: Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France.|Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, Marseille, France.
authors.forename: G
authors.initials: G
authors.lastname: Michel
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects; D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002066:Busulfan / Q000627:therapeutic use; D008076:Cholesterol, HDL / Q000097:blood; D003131:Combined Modality Therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000209:etiology*; D019653:Myeloablative Agonists / Q000009:adverse effects / Q000627:therapeutic use; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000628:therapy*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D017741:Survivors; D019172:Transplantation Conditioning / Q000009:adverse effects*; D055105:Waist Circumference; D014916:Whole-Body Irradiation / Q000009:adverse effects; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D018906:Antineoplastic Agents, Alkylating; D001786:Blood Glucose; D008076:Cholesterol, HDL; D008055:Lipids; D019653:Myeloablative Agonists; D002066:Busulfan