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Transplant Toxicities

Metabolic syndrome in adults who received hematopoietic stem cell transplantation for acute childhood leukemia: an LEA study

Bone Marrow Transplantation volume 50, pages 1438–1444 (2015)Cite this article

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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.

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Acknowledgements

We would like to thank the LEA Study Group (Supplementary Data). The study was supported by the French National Clinical Research Program, the French National Cancer Institute (InCA), the French National Research Agency (ANR), the Cancéropôle PACA, the Regional Council PACA, the Hérault departmental comity of the Ligue contre le Cancer and the French Institute for Public Health Research (IRESP).

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Authors and Affiliations

  1. Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France

    C Oudin, V Barlogis & G Michel

  2. Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, Marseille, France

    C Oudin, P Auquier, J Berbis, C Vercasson, V Barlogis & G Michel

  3. Department of Pediatric Hematology and Oncology, University Hospital of Lyon, Lyon, France

    Y Bertrand

  4. Department of Pediatric Onco-Haematology, Hôpital d’Enfants de Brabois, Vandoeuvre Les Nancy, France

    A Contet

  5. Department of Pediatric Hematology and Oncology, CIC Inserm 501, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France

    J Kanold

  6. Departmnent of Pediatric Hematology and Oncology, University Hospital, Montpellier, France

    N Sirvent

  7. Pediatric Hematology, University Hospital, Saint Etienne, France

    S Thouvenin

  8. Departmnent of Pediatric Hematology, Trousseau Hospital, Paris, France

    M-D Tabone & G Leverger

  9. Department of Pediatric Hematology and Oncology, Hospital University, Strasbourg, France

    P Lutz

  10. Department of Pediatric Hematology and Oncology, University Hospital of Bordeaux, Bordeaux, France

    S Ducassou

  11. Department of Pediatric Hematology and Oncology, University Hospital of Grenoble, Grenoble, France

    D Plantaz

  12. Departmnent of Pediatric Hematology, Robert Debré Hospital, Paris, France

    J-H Dalle & A Baruchel

  13. Department of Pediatric Hematology and Oncology, University Hospital of Rennes, Rennes, France

    V Gandemer

  14. Department of Endocrinology and Nutrition, Timone Hospital Marseille, Marseille, France

    S Beliard

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  1. C Oudin
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Oudin, C., Auquier, P., Bertrand, Y. et al. Metabolic syndrome in adults who received hematopoietic stem cell transplantation for acute childhood leukemia: an LEA study. Bone Marrow Transplant 50, 1438–1444 (2015). https://doi.org/10.1038/bmt.2015.167

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