The association between glucocorticoid therapy and BMI z-score changes in children with acute lymphoblastic leukemia

Abstract

BAZ increased significantly in children with ALL during the initial treatment with the NOPHO ALL 2008 protocol. This is likely associated with the GC administration and influenced by gender and initial BAZ.

No evidence of overweight in long‐term survivors of childhood cancer after glucocorticoid treatment

“…However, the findings of the current study essentially are comforting: treatment with glucocorticoids leads to overweight at the time of treatment, 9,[12][13][14]16 but the results herein suggest that glucocorticoid treatment is not a reason for concern for long-term overweight in CSS. …”

“…6,7 Many childhood cancer survivors (CCS) are reported to be overweight, especially in the United States, despite decreased doses of CRT. 11 To the best of our knowledge, previous studies to date have focused mainly on the acute effects of glucocorticoids during or shortly after treatment, 9,[12][13][14][15][16] have not assessed cumulative glucocorticoid dose, 11,13 and often have relatively low numbers of participants (<200 individuals). 3,7 However, to the best of our knowledge, the question of whether glucocorticoids have a longer-lasting effect on weight is uncertain, and any such effect may depend on the dose and duration of treatment.…”

“…10 In a US study, treatment with glucocorticoids was found to be associated with obesity 25 years after diagnosis among 776 CCS who were treated with CRT, but to our knowledge the cumulative dose and type of glucocorticoid used were not assessed. 11 To the best of our knowledge, previous studies to date have focused mainly on the acute effects of glucocorticoids during or shortly after treatment, 9,[12][13][14][15][16] have not assessed cumulative glucocorticoid dose, 11,13 and often have relatively low numbers of participants (<200 individuals). 9,[12][13][14][15][16][17][18] Thus, to our knowledge, it remains unclear whether glucocorticoids affect overweight in CCS long after treatment.…”

Methanolic Extract from Aerial Parts of Artemisia Annua L. Induces Cytotoxicity and Enhances Vincristine-Induced Anticancer Effect in Pre-B Acute Lymphoblastic Leukemia Cells

“…Acute lymphoblastic leukemia (ALL) affects both children and adults with a peak occurrence at 2 to 5 years of age 1 , 2 , 3 . Despite substantial improvements in treatment of ALL patients, the relapse rate is still considered as a major challenge in these people 4 , 5 . VCR, a microtubule binding agent which arrests dividing cells in metaphase, is a common chemotherapeutic drug used for ALL treatment.…”

Genetics of pleiotropic effects of dexamethasone

“…We evaluated all reported adverse events and identified those that were likely at least partly due to glucocorticoids; these included osteonecrosis, CNS toxicity (not related to high-dose or intrathecal methotrexate), hyperglycemia, hypokalemia, and thrombosis. Because glucocorticoids are known to cause weight gain and decreased growth trajectory, [31–34] we used measures of height and weight (at least monthly per patient) to estimate body mass index (BMI) and the decrease in growth trajectory. In addition, each patient had serial blood samples collected on day 1 of week 7 and week 8 (after 7 continuous days of dexamethasone) of the continuation phase, for assessment of plasma dexamethasone pharmacokinetics, serum lipids, albumin and cortisol levels (See Supplemental Digital Content Text for details) [8, 17, 30].…”