Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Allografting

Degree of fatness after allogeneic BMT for childhood leukaemia or lymphoma

Bone Marrow Transplantation volume 27, pages 817–820 (2001)Cite this article

Abstract

Excess fatness is frequent after childhood ALL treated without BMT. We measured the whole-body percent fat by dual-energy X-ray absorptiometry and the body-mass index (weight/height2 (kg/m2), BMI) in 25 survivors of childhood leukaemia or lymphoma (21 with ALL) who had received TBI and allogeneic BMT a median of 8 years ago (range 4–13). Adjusted for sex and age, the mean BMI was slightly but significantly reduced (0.4 s.d. below predicted) and the whole-body percent fat was significantly increased compared with healthy controls (1.1 s.d. above predicted). Eleven of 25 patients had a percent fat above the 90 percentile of the reference values, which indicates excess fatness. Adjusted for sex and age, a higher percent fat was related to additional cranial irradiation. Controlled for this, the whole-body percent fat seemed to be unrelated to age at BMT, length of follow-up, and previous chemotherapy. Compared with untransplanted ALL survivors treated with cranial irradiation, BMT survivors had significantly reduced BMI but similar whole body percent fat. BMI was a poor measure of body fatness in these patients. In conclusion, survivors of BMT for childhood leukaemia or lymphoma are adipose and slightly underweight and consequently have a substantially reduced lean body mass. Bone Marrow Transplantation (2001) 27, 817–820.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. de Nully Brown P, Olsen JH, Hertz H et al. Trends in survival after childhood cancer in Denmark, 1943–87: a population-based study Acta Paediatr 1995 84: 316–324

    Article  CAS  PubMed  Google Scholar 

  2. Saarinen UM, Mellander L, Nysom K et al. Allogeneic bone marrow transplantation in first remission for children with very high-risk acute lymphoblastic leukemia: a retrospective case-control study in the Nordic countries. Nordic Society for Pediatric Hematology and Oncology (NOPHO) Bone Marrow Transplant 1996 17: 357–363

    CAS  PubMed  Google Scholar 

  3. Barrett AJ, Horowitz MM, Pollock BH et al. Bone marrow transplants from HLA-identical siblings as compared with chemotherapy for children with acute lymphoblastic leukemia in a second remission (see comments) New Engl J Med 1994 331: 1253–1258

    Article  CAS  PubMed  Google Scholar 

  4. Dopfer R, Henze G, Bender-Götze C et al. Allogeneic bone marrow transplantation for childhood acute lymphoblastic leukemia in second remission after intensive primary and relapse therapy according to the BFM- and CoALL-protocols: results of the German Cooperative Study Blood 1991 78: 2780–2784.

    CAS  PubMed  Google Scholar 

  5. Schroeder H, Gustafsson G, Saarinen-Pihkala UM et al. Allogeneic bone marrow transplantation in second remission of childhood acute lymphoblastic leukaemia: a population-based case control study from the Nordic countries Bone Marrow Transplant 1999 23: 555–560

    Article  CAS  PubMed  Google Scholar 

  6. Cole TJ . Weight-stature indices to measure underweight, overweight, and obesity. In: Himes JH (ed.) Anthropometric Assessment of Nutritional Status Wiley-Liss: New York 1991 pp 83–111

    Google Scholar 

  7. Serdula MK, Ivery D, Coates RJ et al. Do obese children become obese adults? A review of the literature Prev Med 1993 22: 167–177

    Article  CAS  PubMed  Google Scholar 

  8. Sørensen TIA, Sonne-Holm S . Risk in childhood of development of severe adult obesity: retrospective, population-based case-cohort study Am J Epidemiol 1988 127: 104–113

    Article  PubMed  Google Scholar 

  9. Must A, Jacques PF, Dallal GE et al. Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935 (see comments) New Engl J Med 1992 327: 1350–1355

    Article  CAS  PubMed  Google Scholar 

  10. Waaler HT . Height, weight and mortality. The Norwegian experience Acta Med Scand Suppl 1984 679: 1–56

    CAS  PubMed  Google Scholar 

  11. Stevens J, Cai J, Pamuk ER et al. The effect of age on the association between body-mass index and mortality (see comments) New Engl J Med 1998 338: 1–7

    Article  CAS  PubMed  Google Scholar 

  12. Sørensen TIA, Price RA . Secular trends in body mass index among Danish young men Int J Obes 1990 14: 411–419

    PubMed  Google Scholar 

  13. Pritchard JE, Nowson CA, Strauss BJ et al. Evaluation of dual energy X-ray absorptiometry as a method of measurement of body fat Eur J Clin Nutr 1993 47: 216–228

    CAS  PubMed  Google Scholar 

  14. Pietrobelli A, Faith MS, Allison DB et al. Body mass index as a measure of adiposity among children and adolescents: a validation study (see comments) J Pediatr 1998 132: 204–210

    Article  CAS  PubMed  Google Scholar 

  15. Shalet SM . Radiation and pituitary dysfunction (editorial; comment) New Engl J Med 1993 328: 131–133

    Article  CAS  PubMed  Google Scholar 

  16. Shalet SM, Didi M, Ogilvy-Stuart AL et al. Growth and endocrine function after bone marrow transplantation Clin Endocrinol (Oxf) 1995 42: 333–339

    Article  CAS  Google Scholar 

  17. Boot AM, Engels MA, Boerma GJ et al. Changes in bone mineral density, body composition, and lipid metabolism during growth hormone (GH) treatment in children with GH deficiency J Clin Endocrinol Metab 1997 82: 2423–2428

    CAS  PubMed  Google Scholar 

  18. Binnerts A, Deurenberg P, Swart GR et al. Body composition in growth hormone-deficient adults Am J Clin Nutr 1992 55: 918–923

    Article  CAS  PubMed  Google Scholar 

  19. Zee P, Chen CH . Prevalence of obesity in children after therapy for acute lymphoblastic leukemia Am J Pediatr Hematol Oncol 1986 8: 294–299

    Article  CAS  PubMed  Google Scholar 

  20. Schell MJ, Ochs J, Schriock EA, Carter M . A method of predicting adult height and obesity in long-term survivors of childhood acute lymphoblastic leukemia J Clin Oncol 1992 10: 128–133

    Article  CAS  PubMed  Google Scholar 

  21. Odame I, Reilly JJ, Gibson BE, Donaldson MD . Patterns of obesity in boys and girls after treatment for acute lymphoblastic leukaemia (see comments) Arch Dis Child 1994 71: 147–149

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Van Dongen-Melman J, Hokken Koelega AC, Hahlen K et al. Obesity after successful treatment of acute lymphoblastic leukemia in childhood Pediatr Res 1995 38: 86–90

    Article  CAS  PubMed  Google Scholar 

  23. Didi M, Didcock E, Davies HA et al. High incidence of obesity in young adults after treatment of acute lymphoblastic leukemia in childhood J Pediatr 1995 127: 63–67

    Article  CAS  PubMed  Google Scholar 

  24. Birkæbk NH, Clausen N . Height and weight pattern up to 20 years after treatment for acute lymphoblastic leukaemia (see comments) Arch Dis Child 1998 79: 161–164

    Article  Google Scholar 

  25. Nysom K, Holm K, Michaelsen KF et al. Degree of fatness after treatment for acute lymphoblastic leukaemia in childhood J Clin Endocrinol Metab 1999 84: 4591–4596

    CAS  PubMed  Google Scholar 

  26. Warner JT, Bell W, Webb DK, Gregory JW . Relationship between cardiopulmonary response to exercise and adiposity in survivors of childhood malignancy Arch Dis Child 1997 76: 298–303

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Brennan BMD, Rahim A, Blum WF et al. Hyperleptinaemia in young adults following cranial irradiation in childhood: growth hormone deficiency or leptin insensitivity? Clin Endocrinol (Oxf) 1999 50: 163–169

    Article  CAS  Google Scholar 

  28. Cohen A, Duell T, Socié G et al. Nutritional status and growth after bone marrow transplantation (BMT) during childhood: EBMT Late-Effects Working Party retrospective data. European Group for Blood and Marrow Transplantation Bone Marrow Transplant 1999 23: 1043–1047

    Article  CAS  PubMed  Google Scholar 

  29. Nysom K, Holm K, Hesse B et al. Lung function after allogeneic bone marrow transplantation for leukaemia or lymphoma Arch Dis Child 1996 74: 432–436

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Holm K, Nysom K, Rasmussen MH et al. Growth, growth hormone and final height after BMT. Possible recovery of irradiation-induced growth hormone insufficiency Bone Marrow Transplant 1996 18: 163–170

    CAS  PubMed  Google Scholar 

  31. Nysom K, Holm K, Michaelsen KF et al. Bone mass after allogeneic BMT for childhood leukaemia or lymphoma Bone Marrow Transplant 2000 25: 191–196

    Article  CAS  PubMed  Google Scholar 

  32. Rolland-Cachera MF, Cole TJ, Sempé M et al. Body mass index variations: centiles from birth to 87 years Eur J Clin Nutr 1991 45: 13–21

    CAS  PubMed  Google Scholar 

  33. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey Br Med J 2000 320: 1240–1243

    Article  CAS  Google Scholar 

  34. WHO Obesity: preventing and managing the global epidemic: report of a WHO consultation on obesity, Geneva 3–5 June 1997 World Health Organization: Geneva, 1998

  35. Lange P, Parner J, Vestbo J et al. A 15-year follow-up study of ventilatory function in adults with asthma New Engl J Med 1998 339: 1194–1200

    Article  CAS  PubMed  Google Scholar 

  36. Cole TJ, Green PJ . Smoothing reference centile curves: the LMS method and penalized likelihood Stat Med 1992 11: 1305–1319

    Article  CAS  PubMed  Google Scholar 

  37. SAS Institute Inc . SAS/STAT(R) User's Guide, Version 6. 4 edn SAS Institute: Cary, NC 1989

    Google Scholar 

  38. Poskitt EM . Defining childhood obesity: the relative body mass index (BMI). European Childhood Obesity group Acta Paediatr 1995 84: 961–963

    Article  CAS  PubMed  Google Scholar 

  39. Warner JT, Bell W, Webb DK, Gregory JW . Daily energy expenditure and physical activity in survivors of childhood malignancy Pediatr Res 1998 43: 607–613

    Article  CAS  PubMed  Google Scholar 

  40. Groot-Loonen JJ, Otten BJ, van't Hof MA et al. Influence of treatment modalities on body weight in acute lymphoblastic leukemia Med Pediatr Oncol 1996 27: 92–97

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We thank Tim Cole for helpful comments on LMS modelling of control data. Karsten Nysom received financial support from the Interdisciplinary Steering Committee of the Finsen Centre, the Torkil Steenbeck Foundation, the Ville Heise Foundation, and the Rosalie Petersen Foundation; Kirsten Holm received financial support from the Danish Cancer Society (grant No. 92–016); Christian Mølgaard received financial support from FØTEK (Food Technology Research and Development Programme) and the Danish Dairy Research Foundation.

Author information

Authors and Affiliations

  1. Section of Paediatric Haematology and Oncology, The Juliane Marie Centre, Rigshospitalet, Denmark

    K Nysom & H Hertz

  2. Section of Growth and Reproduction, The Juliane Marie Centre, Rigshospitalet, Denmark

    K Holm & J Müller

  3. Research Department of Human Nutrition and Centre for Advanced Food Studies, The Royal Veterinary and Agricultural University, Frederiksberg, Denmark

    KF Michaelsen & C Mølgaard

  4. Paediatric Nutrition Unit, The Juliane Marie Centre, Rigshospitalet, Denmark

    KF Michaelsen

  5. BMT Unit, The Finsen Centre, Rigshospitalet, Copenhagen, Denmark

    N Jacobsen

Authors
  1. K Nysom
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K Holm
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. KF Michaelsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H Hertz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. N Jacobsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J Müller
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. C Mølgaard
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nysom, K., Holm, K., Michaelsen, K. et al. Degree of fatness after allogeneic BMT for childhood leukaemia or lymphoma. Bone Marrow Transplant 27, 817–820 (2001). https://doi.org/10.1038/sj.bmt.1703012

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1703012

Keywords

This article is cited by

Search

Advanced search

Quick links