title: Metabolic syndrome in long-term survivors of childhood acute leukemia treated without hematopoietic stem cell transplantation: an L.E.A. study.
abstract: Cardiovascular conditions are serious long-term complications of childhood acute leukemia. However, few studies have investigated the risk of metabolic syndrome, a known predictor of cardiovascular disease, in patients treated without hematopoietic stem cell transplantation. We describe the overall and age-specific prevalence, and the risk factors for metabolic syndrome and its components in the L.E.A. (Leucémie de l'Enfant et de l'Adolescent) French cohort of childhood acute leukemia survivors treated without hematopoietic stem cell transplantation. The study included 650 adult patients (mean age at evaluation: 24.2 years; mean follow-up after leukemia diagnosis: 16.0 years). The prevalence of metabolic syndrome was 6.9% (95% CI 5.1-9.2). The age-specific cumulative prevalence at 20, 25, 30 and 35 years of age was 1.3%, 6.1%, 10.8% and 22.4%, respectively. The prevalence of decreased high-density lipoprotein cholesterol, increased triglycerides, increased fasting glucose, increased blood pressure and increased abdominal circumference was 26.8%, 11.7%, 5.8%, 36.7% and 16.7%, respectively. Risk factors significantly associated with metabolic syndrome in the multivariate analysis were male sex (OR 2.64; 95% CI 1.32-5.29), age at last evaluation (OR 1.10; 95% CI 1.04-1.17) and body mass index at diagnosis (OR 1.15; 95% CI 1.01-1.32). The cumulative steroid dose was not a significant risk factor. Irradiated and non-irradiated patients exhibited different patterns of metabolic abnormalities, with more frequent abdominal obesity in irradiated patients and more frequent hypertension in non-irradiated patients. Survivors of childhood acute leukemia are at risk of metabolic syndrome, even when treated without hematopoietic stem cell transplantation or central nervous system irradiation. A preventive approach with regular screening for cardiovascular risk factors is recommended. clinicaltrials.gov identifier:01756599.
authors: Department of Pediatric Hematology and Oncology, Timone Enfants Hospital, APHM and Aix-Marseille University, Marseille, France paul.saultier@gmail.com.
authors: Paul
authors: P
authors: Saultier
authors: Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital, Marseille, France.
authors: Pascal
authors: P
authors: Auquier
authors: Department of Pediatric Hematology and Oncology, University Hospital of Lyon, France.
authors: Yves
authors: Y
authors: Bertrand
authors: Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital, Marseille, France.
authors: Camille
authors: C
authors: Vercasson
authors: Department of Pediatric Hematology and Oncology, Timone Enfants Hospital, APHM and Aix-Marseille University, Marseille, France.|Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital, Marseille, France.
authors: Claire
authors: C
authors: Oudin
authors: Department of Pediatric Onco-Hematology, Hôpital d'Enfants de Brabois, Vandoeuvre-les-Nancy, France.
authors: Audrey
authors: A
authors: Contet
authors: Department of Pediatric Hematology-Oncology, University Hospital of Grenoble, France.
authors: Dominique
authors: D
authors: Plantaz
authors: Pediatric Hematology and Oncology department, University Hospital L'Archet, Nice, France.
authors: Marilyne
authors: M
authors: Poirée
authors: Department of Pediatric Hematology and Oncology, University Hospital of Bordeaux, France.
authors: Stéphane
authors: S
authors: Ducassou
authors: Department of Pediatric Hematology and Oncology, CIC Inserm 501, University Hospital of Clermont-Ferrand, France.
authors: Justyna
authors: J
authors: Kanold
authors: Pediatric Hematology Department, Trousseau Hospital, Paris, France.
authors: Marie-Dominique
authors: MD
authors: Tabone
authors: Pediatric Hematology Department, Robert Debré Hospital, Paris, France.
authors: Jean-Hugues
authors: JH
authors: Dalle
authors: Department of Pediatric Hematology-Oncology, Hospital University, Strasbourg, France.
authors: Patrick
authors: P
authors: Lutz
authors: Department of Pediatric Hematology and Oncology, University Hospital of Rennes, France.
authors: Virginie
authors: V
authors: Gandemer
authors: Pediatric Hematology and Oncology department, University Hospital, Montpellier, France.
authors: Nicolas
authors: N
authors: Sirvent
authors: Pediatric Hematology, University Hospital, Saint Etienne, France.
authors: Sandrine
authors: S
authors: Thouvenin
authors: Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital, Marseille, France.
authors: Julie
authors: J
authors: Berbis
authors: Department of Pediatric Hematology and Oncology, Timone Enfants Hospital, APHM and Aix-Marseille University, Marseille, France.
authors: Hervé
authors: H
authors: Chambost
authors: Pediatric Hematology Department, Robert Debré Hospital, Paris, France.
authors: André
authors: A
authors: Baruchel
authors: Pediatric Hematology Department, Trousseau Hospital, Paris, France.
authors: Guy
authors: G
authors: Leverger
authors: Department of Pediatric Hematology and Oncology, Timone Enfants Hospital, APHM and Aix-Marseille University, Marseille, France.|Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital, Marseille, France.
authors: Gérard
authors: G
authors: Michel
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007938:Leukemia / Q000150:complications* / Q000628:therapy; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000209:etiology*; D015995:Prevalence; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D012074:Remission Induction; D012307:Risk Factors; D017741:Survivors; D055815:Young Adult