Metabolic syndrome in long-term survivors of childhood acute leukemia ă treated without hematopoietic stem cell transplantation: an LEA study

Marie-Dominique Tabone, Jean-Hugues Dalle (), Patrick Lutz, Virginie Gandemer, Nicolas Sir Vent, Sandrine Thouvenin, Julie Berbis (), Hervé Chambost, André Baruchel, Guy Leverger, Gérard Michel, Paul Saultier, Pascal Auquier (), Yves Bertrand (), Camille Vercasson, Claire Oudin, Audrey Contet, Dominique Plantaz, Marilyne Poiree, Stéphane Ducassou and Justyna Kanold
Additional contact information
Marie-Dominique Tabone: CHU Trousseau [APHP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - SU - Sorbonne Université
Jean-Hugues Dalle: Hôpital Robert Debré Paris - Hôpital Robert Debré - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
Patrick Lutz: Service de pédiatrie - CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
Virginie Gandemer: IGDR - Institut de Génétique et Développement de Rennes - UR - Université de Rennes - CNRS - Centre National de la Recherche Scientifique - Biosit : Biologie - Santé - Innovation Technologique - Structure Fédérative de Recherche en Biologie et Santé de Rennes, Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Julie Berbis: SPMC - Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants - AMU - Aix Marseille Université - APHM - Assistance Publique - Hôpitaux de Marseille
Hervé Chambost: Service de pédiatrie spécialisée et médecine infantile (neurologie, pneumologie, maladies héréditaires du métabolisme) [Hôpital de la Timone - APHM] - TIMONE - Hôpital de la Timone [CHU - APHM]
André Baruchel: Service d'hématologie et immunologie pédiatrique - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Robert Debré - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - UPD7 - Université Paris Diderot - Paris 7
Guy Leverger: Hôpital Trousseau - CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
Gérard Michel: Pédiatrie et oncologie pédiatrique [Hôpital de la Timone - APHM] - AMU - Aix Marseille Université - APHM - Assistance Publique - Hôpitaux de Marseille - TIMONE - Hôpital de la Timone [CHU - APHM]
Paul Saultier: NORT - Nutrition, obésité et risque thrombotique - INRA - Institut National de la Recherche Agronomique - AMU - Aix Marseille Université - INSERM - Institut National de la Santé et de la Recherche Médicale
Pascal Auquier: SPMC - Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants - AMU - Aix Marseille Université - APHM - Assistance Publique - Hôpitaux de Marseille
Yves Bertrand: Hématologie et immunologie pédiatrique - HFME - Hôpital Femme Mère Enfant [CHU - HCL] - HCL - Hospices Civils de Lyon - HCL - Hospices Civils de Lyon - CHU Lyon - IHOPe - Institut d'hématologie et d'oncologie pédiatrique [CHU - HCL] - HCL - Hospices Civils de Lyon
Camille Vercasson: SPMC - Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants - AMU - Aix Marseille Université - APHM - Assistance Publique - Hôpitaux de Marseille
Claire Oudin: Service d'hématologie pédiatrique - Université de la Méditerranée - Aix-Marseille 2 - APHM - Assistance Publique - Hôpitaux de Marseille - TIMONE - Hôpital de la Timone [CHU - APHM]
Audrey Contet: Unité de Transplantation Médullaire - CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy - Hôpital d'enfants
Dominique Plantaz: Service Hématologie Infantile - CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
Stéphane Ducassou: Hôpital Pellegrin - CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux - Groupe hospitalier Pellegrin
Justyna Kanold: SHOP - Service Hématologie et Oncologie Pédiatrique [CHU Clermont-Ferrand] - CHU Estaing [Clermont-Ferrand] - CHU Clermont-Ferrand - Pôle Femme et Enfant [CHU Clermont-Ferrand] - CHU Estaing [Clermont-Ferrand] - CHU Clermont-Ferrand

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Abstract: Cardiovascular conditions are serious long-term complications of childhood acute leukemia. However, few studies have investigated the risk of metabolic syndrome, a known predictor of cardiovascular disease, in patients treated without hematopoietic stem cell transplantation. We describe the overall and age-specific prevalence, and the risk factors for metabolic syndrome and its components in the L.E.A. (Leucémie de l'Enfant et de l'Adolescent) French cohort of childhood acute leukemia survivors treated without hematopoietic stem cell transplantation. The study included 650 adult patients (mean age at evaluation: 24.2 years; mean follow-up after leukemia diagnosis: 16.0 years). The prevalence of metabolic syndrome was 6.9% (95% CI 5.1-9.2). The age-specific cumulative prevalence at 20, 25, 30 and 35 years of age was 1.3%, 6.1%, 10.8% and 22.4%, respectively. The prevalence of decreased high-density lipoprotein cholesterol, increased triglycerides, increased fasting glucose, increased blood pressure and increased abdominal circumference was 26.8%, 11.7%, 5.8%, 36.7% and 16.7%, respectively. Risk factors significantly associated with metabolic syndrome in the multivariate analysis were male sex (OR 2.64; 95% CI 1.32-5.29), age at last evaluation (OR 1.10; 95% CI 1.04-1.17) and body mass index at diagnosis (OR 1.15; 95% CI 1.01-1.32). The cumulative steroid dose was not a significant risk factor. Irradiated and non-irradiated patients exhibited different patterns of metabolic abnormalities, with more frequent abdominal obesity in irradiated patients and more frequent hypertension in non-irradiated patients. Survivors of childhood acute leukemia are at risk of metabolic syndrome, even when treated without hematopoietic stem cell transplantation or central nervous system irradiation. A preventive approach with regular screening for cardiovascular risk factors is recommended. clinicaltrials.gov identifier:01756599.

Keywords: quality (search for similar items in EconPapers)
Date: 2016-12
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Published in Haematologica, 2016, 101 (12), pp.1603-1610. ⟨10.3324/haematol.2016.148908⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-01482380

DOI: 10.3324/haematol.2016.148908

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