title: Clinical and biological markers of premature aging after autologous SCT in childhood cancer.
abstract: The aim of this study was to analyze the prevalence of frailty and physical health limitations among long-term survivors of high-risk neuroblastoma (HR NBL) and to investigate whether frail health is associated with variables of cardiovascular function, markers of inflammation and telomere length. A national study cohort of 19 (median age 22, range 16-30 years) long-term (>10 years) HR NBL survivors was studied and the findings were compared with 20 age- and sex-matched controls. Frailty was defined as ⩾3 of the following conditions: low muscle mass, low energy expenditure, slow running and weakness. The prevalence of frailty was significantly higher among the HR NBL survivors 9/19 (47%) than among the controls (0%). Thirteen (68%) of the survivors reported significant physical health limitations in vigorous activities, as opposed to none of the controls. The HR NBL survivors had significantly shorter telomere length and higher serum levels of high sensitivity C-reactive protein than did the controls. Frail health and poor physical functioning are prevalent among HR NBL survivors and suggest premature aging. Survivors with gonadal damage, very low fat mass percentage, low glycosylated hemoglobin A1c and increased common carotid artery intima-media thickness may be more prone to early aging after high dose therapy.
authors.affiliation: Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Vatanen
authors.affiliation: Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Hou
authors.affiliation: Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Huang
authors.affiliation: Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden.
authors.forename: O
authors.initials: O
authors.lastname: Söder
authors.affiliation: Division of Pediatric Nephrology and Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Jahnukainen
authors.affiliation: Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Kurimo
authors.affiliation: Division of Cardiology, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: T H
authors.initials: TH
authors.lastname: Ojala
authors.affiliation: Division of Cardiology, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Sarkola
authors.affiliation: Division of Cardiology, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Turanlahti
authors.affiliation: Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: U M
authors.initials: UM
authors.lastname: Saarinen-Pihkala
authors.affiliation: Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.|Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Jahnukainen
mesh_terms: D000293:Adolescent; D000328:Adult; D019588:Aging, Premature / Q000175:diagnosis*; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D059168:Carotid Intima-Media Thickness; D015331:Cohort Studies; D005260:Female; D000073496:Frailty / Q000175:diagnosis; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009447:Neuroblastoma / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D015995:Prevalence; D017741:Survivors; D016615:Telomere / Q000648:ultrastructure; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein