Obesity and Sarcopenia in Survivors of Childhood Acute Lymphoblastic Leukemia

Malhotra, Payal; Kapoor, Gauri; Jain, Sandeep; Jain, Silky; Sharma, Anurag

doi:10.1007/s13312-021-2213-7

Cited by 10 publications

(6 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Metabolic syndrome and altered body composition are emerging chronic health issues among Indian survivors of childhood cancer. 10,21 In our cohort, survivors with diagnoses of retinoblastoma, brain tumor, and nasopharyngeal carcinoma had the highest cumulative incidence of late effects grade 3 and above, possibly because of the large proportion of patients who underwent radiation and enucleation (in retinoblastoma) and use of cranial-directed radiotherapy in the others. Similarly, a high proportion of bone tumors underwent surgeries such as amputation and chemotherapy with alkylating agent and anthracyclines.…”

Section: Discussionmentioning

confidence: 78%

See 1 more Smart Citation

Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India

Prasad

Goswami

Chinnaswamy

et al. 2022

JCO Global Oncology

View full text Add to dashboard Cite

PURPOSE Despite an increasing number of survivors of childhood cancer (CCS) in low- and middle-income countries, survivorship care is in its nascent stages. We describe the spectrum of late effects seen, challenges faced, and lessons learnt over three decades of a late effects program in India. METHODS We describe the demographics and profile of late effects of all CCS survivors enrolled in our After Completion of Treatment Clinic from February 5, 1991 (inception) to February 4, 2021. We analyzed the trends by the decade of diagnosis. RESULTS There were 3,067 CCS survivors, the median age was 18 years (range, 3-57 years), and the median follow-up was 11 years (range, 2-46 years). Two thirds (62.4%) had either no or mild late effects, 480 (15.6%), 497 (16.2%), and 162 (5.3%) had grades 2, 3, and 4 late effects, with 67 deaths reported. Notable late effects were chronic viral hepatitis (7.8%), thyroid dysfunction (7.5%), other endocrine issues (13.6%), psychosocial issues (57%), neurocognitive impairment (4.1%), and metabolic syndrome (4%). The cumulative incidence and severity of late effects showed a consistent decline by the decade of diagnosis. Twenty-two percent of survivors are lost to follow-up. CONCLUSION Survivors of childhood cancer treated on contemporary treatment protocols have a significantly lower side-effect profile. Attrition to long-term follow-up and psychosocial issues are significant concerns. Understanding the unique spectrum of late effects and establishing a holistic support system go a long way in ensuring the long-term physical and mental health and psychosocial concerns of childhood cancer survivors in low- and middle-income countries.

show abstract

Section: Discussionmentioning

confidence: 78%

“…Metabolic syndrome and altered body composition are emerging chronic health issues among Indian survivors of childhood cancer. 10 , 21 …”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India

Prasad

Goswami

Chinnaswamy

et al. 2022

JCO Global Oncology

View full text Add to dashboard Cite

show abstract

“…In the pediatric population, SO has been most commonly studied in children with acute lymphocytic leukemia (ALL). The findings show a frequent occurrence of SO during treatment and even years after survival [105][106][107][108]. Children with hematologic malignancies had more significant increases in fat mass than children with solid organ tumors [68].…”

Section: Sarcopenic Obesitymentioning

confidence: 82%

Sarcopenia in Children with Solid Organ Tumors: An Instrumental Era

Ritz

Lurz

Berger

2022

Cells

View full text Add to dashboard Cite

Sarcopenia has recently been studied in both adults and children and was found to be a prognostic marker for adverse outcome in a variety of patient groups. Our research showed that sarcopenia is a relevant marker in predicting outcome in children with solid organ tumors, such as hepatoblastoma and neuroblastoma. This was especially true in very ill, high-risk groups. Children with cancer have a higher likelihood of ongoing loss of skeletal muscle mass due to a mismatch in energy intake and expenditure. Additionally, the effects of cancer therapy, hormonal alterations, chronic inflammation, multi-organ dysfunction, and a hypermetabolic state all contribute to a loss of skeletal muscle mass. Sarcopenia seems to be able to pinpoint this waste to a high degree in a new and objective way, making it an additional tool in predicting and improving outcome in children. This article focuses on the current state of sarcopenia in children with solid organ tumors. It details the pathophysiological mechanisms behind sarcopenia, highlighting the technical features of the available methods for measuring muscle mass, strength, and function, including artificial intelligence (AI)-based techniques. It also reviews the latest research on sarcopenia in children, focusing on children with solid organ tumors.

show abstract

“…Several studies showed that CCS are prone to an excessive weight gain than their peers, due to glucocorticoids treatment, increased rate of hormonal dysfunction, excessive dietary intake, and a low level of physical exercise [4,5,36]. The prevalence of overweight and obesity in the previous published cohorts of CCS differs widely, according to age, follow-up duration, ethnicity, and social factors, as well as the prevalence of obesity in the general population of each country [37,38]. In our series, the prevalence of overweight (26.2%) and obesity (11.1%) was higher than indicated in the 2019 report of the Italian National Institute of Statistics (ISTAT) for the general population of the same age and country (15.8% and 3.0%, respectively), thus confirming the already reported tendency to overweight of childhood cancer survivors [39].…”

Section: Discussionmentioning

confidence: 99%

Influence of Body Mass Index, Cancer Type and Treatment on Long-Term Metabolic and Liver Outcomes in Childhood Cancer Survivors

Milluzzo

Manuella

Cannata

et al. 2022

JCM

View full text Add to dashboard Cite

In the last decade, the survival of subjects affected by cancer in childhood has significantly improved. The increased lifespan of childhood cancer survivors (CCS) led to a greater risk for long-term, therapy-related morbidity. To identify the clinical predictors of metabolic adverse outcomes in CCS (average off-therapy period: 12 years), we recruited 126 survivors of different childhood cancers (86.5% hematological cancers) who received at least anticancer chemotherapy, consecutively approached during their annual oncohematological outpatient visit. At examination, anthropometric measures and cancer-related history were collected. Moreover, a fasting venous sample was carried out for measuring fasting plasma glucose and insulin, glycated hemoglobin, lipid panel, and transaminases. We calculated the indexes of insulin resistance (HOMA-IR, McAuley, and QUICKI) and secretion (HOMA-β), liver steatosis (Hepatic Steatosis Index) and fibrosis (FIB-4 and NAFLD fibrosis score), and visceral fat dysfunction (Visceral Adiposity Index). More than one-third of the subjects (37.3%) did not have normal weight, with 11.1% of them affected by obesity. At recruitment, obese subjects were at significantly higher risk for impaired fasting glucose, metabolic syndrome, visceral adipose dysfunction, and liver steatosis/fibrosis. Subjects who received bone marrow transplantation were prone to insulin resistance, while survivors of lymphoma presented a visceral adipose dysfunction These results suggest a carefully metabolic monitoring of CCS, particularly in subgroups at higher risk, to early detect these conditions, promptly begin therapeutic interventions, and mitigate the dysmetabolic-related health burden.

show abstract

Obesity and Sarcopenia in Survivors of Childhood Acute Lymphoblastic Leukemia

Cited by 10 publications

References 14 publications

Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India

Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India

Sarcopenia in Children with Solid Organ Tumors: An Instrumental Era

Influence of Body Mass Index, Cancer Type and Treatment on Long-Term Metabolic and Liver Outcomes in Childhood Cancer Survivors

Contact Info

Product

Resources

About