Page 101 - Haematologica-April 2018

Complications in Hematology
Prevalence and characteristics of metabolic syndrome in adults from the French childhood leukemia survivors’ cohort: a comparison with controls from the French population
Claire Oudin,1,2 Julie Berbis,2 Yves Bertrand,3 Camille Vercasson,2
Frédérique Thomas,4 Pascal Chastagner,5 Stéphane Ducassou,6
Justyna Kanold,7 Marie-Dominique Tabone,8 Catherine Paillard,9
Marilyne Poirée,10 Dominique Plantaz,11 Jean-Hugues Dalle,12
Virginie Gandemer,13 Sandrine Thouvenin,14 Nicolas Sirvent,15 Paul Saultier,1 Sophie Béliard,16 Guy Leverger,8 André Baruchel,12 Pascal Auquier,2
Ferrata Storti Foundation
Bruno Pannier4 and Gérard Michel1,2
Haematologica 2018 Volume 103(4):645-654
1Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille; 2Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital, Marseille; 3Department of Pediatric Hematology and Oncology, University Hospital of Lyon; 4Preventive and Clinical Investigation Centre, Paris; 5Department of Pediatric Onco-Haematology, Children’s Hospital of Brabois, Vandoeuvre Les Nancy; 6Department of Pediatric Hematology and Oncology, University Hospital of Bordeaux; 7Department of Pediatric Hematology and Oncology, CIC Inserm 501, University Hospital of Clermont-Ferrand; 8Pediatric Hematology Department, Trousseau Hospital, Paris; 9Department of Pediatric Hematology-Oncology, University Hospital, Strasbourg; 10Pediatric Hematology and Oncology Department, University Hospital L’Archet, Nice; 11Department of Pediatric Hematology-Oncology, University Hospital of Grenoble; 12Pediatric Hematology Department, Robert Debré Hospital, Paris; 13Department of Pediatric Hematology and Oncology, University Hospital of Rennes; 14Pediatric Hematology, University Hospital, Saint Etienne; 15Pediatric Hematology and Oncology Department, University Hospital, Montpellier and 16Department of Endocrinology and Nutrition, Timone Hospital, Marseille, France
ABSTRACT
The prevalence of the metabolic syndrome among adults from the French LEA childhood acute leukemia survivors’ cohort was prospectively evaluated considering the type of anti-leukemic treatment received, and compared with that of controls. The metabolic profile of these patients was compared with that of controls. A total of 3203 patients from a French volunteer cohort were age- and sex- matched 3:1 to 1025 leukemia survivors (in both cohorts, mean age: 24.4 years; females: 51%). Metabolic syndrome was defined according to the National Cholesterol Education Program’s Adult Treatment Panel III cri- teria. Metabolic syndrome was found in 10.3% of patients (mean fol- low-up duration: 16.3±0.2 years) and 4.5% of controls, (OR=2.49; P<0.001). Patients transplanted with total body irradiation presented the highest risk (OR=6.26; P<0.001); the other treatment groups also showed a higher risk than controls, including patients treated with chemotherapy only. Odd Ratios were 1.68 (P=0.005) after chemothera- py only, 2.32 (P=0.002) after chemotherapy and cranial irradiation, and 2.18 (P=0.057) in patients transplanted without irradiation. Total body irradiation recipients with metabolic syndrome displayed a unique pro- file compared with controls: smaller waist circumference (91 vs. 99.6 cm; P=0.01), and increased triglyceride levels (3.99 vs. 1.5 mmol/L; P<0.001), fasting glucose levels (6.2 vs. 5.6 mmol/L; P=0.049), and systolic blood pressure (137.9 vs. 132.8 mmHg; P=0.005). By contrast, cranial irradia- tion recipients with metabolic syndrome had a larger waist circumfer- ence (109 vs. 99.6 cm; P=0.007) than controls. Regardless of the anti- leukemic treatment, metabolic syndrome risk was higher among child- hood leukemia survivors. Its presentation differed depending on the treatment type, thus suggesting a divergent pathophysiology. This study is registered at clinicaltrials.gov identifier: 01756599.
Correspondence:
gmichel@ap-hm.fr
Received: July 10, 2017. Accepted: January 17, 2018. Pre-published: January 19, 2018.
doi:10.3324/haematol.2017.176123
Check the online version for the most updated information on this article, online supplements, and information on authorship & disclosures: www.haematologica.org/content/103/4/645
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haematologica | 2018; 103(4)
645
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