Features of the metabolic syndrome present in survivors of bone marrow transplantation in adulthood

Noon, Charles; Davies, Margaret; Howlett, Trevor A.; Hunter, Ann

doi:10.1038/sj.bmt.1705060

Cited by 6 publications

(10 citation statements)

References 9 publications

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“…It has been widely reported that HSCT has long-term effects on endocrine function but, apart from two pediatric series 15,16 and some reports in adult patients, 17,18 less is known about the prevalence of MS. The distinction between pediatric and adult patients is not trivial because factors, such as growth hormone replacement therapy, cranial radiotherapy and a high prevalence of acute lymphoblastic leukemia are peculiar to the former and have no clear-cut counterpart in the latter.…”

Section: Discussionmentioning

confidence: 99%

“…The features of MS have also been reported in series of pediatric survivors after hematopoietic stem cell transplantation (HSCT), 15,16 and similar findings have been more sporadically reported in adult recipients. [17][18][19] The aim of this study was to evaluate a series of adult long-term HSCT survivors to determine the prevalence and characteristics of MS, and seek possible differences from spontaneously occurring MS.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of metabolic syndrome in long-term survivors of hematopoietic stem cell transplantation

Annaloro

Usardi

Airaghi

et al. 2008

Bone Marrow Transplant

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Our purpose was to determine the prevalence and features of metabolic syndrome (MS) in a series of long-term hematopoietic stem cell transplantation (HSCT) survivors. We assessed the clinical, metabolic and endocrinological data, and plasma TNF, leptin, resistin and adiponectin levels relating to 85 HSCT recipients. MS was diagnosed on the basis of the National Cholesterol Education Program-Adult Treatment Panel III criteria. Its prevalence was compared with that observed in an Italian population, and its relationship with the clinical and laboratory parameters was assessed univariately and multivariately. Twenty-nine HSCT recipients had MS instead of the 12.8 expected (P<0.0001), with hypertriglyceridemia being the most common feature. Univariate analysis indicated that high insulin and leptin levels, low-adiponectin levels and hypogonadism were significantly related to a diagnosis of MS; multivariate analysis indicated plasma leptin, insulin resistance, age and hypogonadism. We conclude that HSCT recipients are at increased risk of a form of MS that has particular clinical features. Plasma leptin levels are independently related to MS, thus suggesting that leptin resistance may play a role as a pathogenetic clue, as in other conditions in which MS occurs as a secondary phenomenon. MS deserves consideration as a life-threatening complication in patients who are probably cured of their underlying disease.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of metabolic syndrome in long-term survivors of hematopoietic stem cell transplantation

Annaloro

Usardi

Airaghi

et al. 2008

Bone Marrow Transplant

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“…Currently, it is becoming clear from a number of studies among adult and pediatric recipients of BMT that they are also at risk of developing abdominal adiposity, IR and other features of MS, such as impaired glucose tolerance, T2DM, dyslipidemia, and hypertension. Early unexplained mortality in adult recipients of BMT has raised concerns regarding accelerated cardiovascular risk in this group of patients (Higgins et al 2004;Chatterjee et al 2005;Neville et al 2006;Shalitin et al 2006;Baker et al 2007;Taskinen et al 2007). The relative risk is infl uenced by the underlying disease, previous treatments (cranial RT or alkylating CT agents), post-BMT treatments, older age and advanced pubertal stage at BMT, GH defi ciency, and genetic predisposition (family history of dyslipidemia and T2DM) (Shalitin et al 2006).…”

Section: Bone Marrow Transplantationmentioning

confidence: 99%

Detection of metabolic syndrome features among childhood cancer survivors: A target to prevent disease

Siviero-Miachon

Spinola-Castro²,

Guerra³

2008

VHRM

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Along with the growing epidemic of obesity, the risk of atherosclerosis, cardiovascular disease morbidity, and mortality are increasing markedly. Several risk factors for cardiovascular disease, such as visceral obesity, glucose intolerance, arterial hypertension, and dyslipidemia commonly cluster together as a condition currently known as metabolic syndrome. Thus far, insulin resistance, and endothelial dysfunction are the primary events of the metabolic syndrome. Several groups have recommended clinical criteria for the diagnosis of metabolic syndrome in adults. Nonetheless, in what concerns children and adolescents, there are no unifi ed defi nitions, and modifi ed adult criteria have been suggested by many authors, despite major problems. Some pediatric disease states are at risk for premature cardiovascular disease, with clinical coronary events occurring very early in adult life. Survivors of specifi c pediatric cancer groups, particularly acute lymphocytic leukemia, central nervous system tumors, sarcomas, lymphomas, testicular cancer, and following bone marrow transplantation, may develop metabolic syndrome traits due to: hormonal defi ciencies (growth hormone defi ciency, thyroid dysfunction, and gonadal failure), drug or radiotherapy damage, endothelial impairment, physical inactivity, adipose tissue dysfunction, and/or drug-induced magnesium defi ciency. In conclusion, some primary and secondary prevention remarks are proposed in order to reduce premature cardiovascular disease risk in this particular group of patients.

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“…There is not consensus regarding a MetSyn definition in children, likely contributing to this variability. Similarly, among mixed cohorts of adult autologous and allogeneic HCT survivors, the estimates have ranged widely from 25% to 49%, anywhere from a median of 3 to 9 years after HCT [9,20,21]. Some investigators suggest that these clinical findings can present quite early after HCT.…”

Section: Introductionmentioning

confidence: 99%

Metabolic Syndrome after Hematopoietic Cell Transplantation: At the Intersection of Treatment Toxicity and Immune Dysfunction

Turcotte

Yingst

Verneris

2016

Biology of Blood and Marrow Transplantation

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Hematopoietic cell transplantation (HCT) survivors face a multitude of short- and long-term health complications in the years after treatment. One important health complication that is associated with significant morbidity is metabolic syndrome (MetSyn). This constellation of findings, which includes obesity, glucose and lipid dysmetabolism, and hypertension, places affected individuals at increased risk for type 2 diabetes mellitus, cardiovascular complications, and stroke. Previous studies have linked MetSyn in HCT survivors to prior treatment; however, few studies have addressed the potential roles of systemic inflammation and immune system dysfunction after HCT. Within this review, we address the recent advances in the understanding of adipose tissue biology, immune, and inflammatory mechanisms involved in MetSyn in non-HCT patients, and lastly, we discuss potential novel mechanisms that may play a role in MetSyn development after HCT, such as hematopoietic stem cell source, inflammatory status of the stem cell donor, and microbiome composition, all of which represent potential new directions for post-HCT MetSyn research.

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Features of the metabolic syndrome present in survivors of bone marrow transplantation in adulthood

Cited by 6 publications

References 9 publications

Prevalence of metabolic syndrome in long-term survivors of hematopoietic stem cell transplantation

Prevalence of metabolic syndrome in long-term survivors of hematopoietic stem cell transplantation

Detection of metabolic syndrome features among childhood cancer survivors: A target to prevent disease

Metabolic Syndrome after Hematopoietic Cell Transplantation: At the Intersection of Treatment Toxicity and Immune Dysfunction

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