Early signs of metabolic syndrome in pediatric central nervous system tumor survivors after high-dose chemotherapy and autologous stem-cell transplantation and radiation.
Dyslipidemia
Hypertension
Obesity
Stem-cell transplant
The metabolic syndrome
Journal
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
ISSN: 1433-0350
Titre abrégé: Childs Nerv Syst
Pays: Germany
ID NLM: 8503227
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
received:
13
07
2020
accepted:
11
11
2020
pubmed:
19
11
2020
medline:
29
6
2021
entrez:
18
11
2020
Statut:
ppublish
Résumé
Cancer survivors treated with stem-cell transplant (SCT) and radiation therapy are at a high risk for late effects including the metabolic syndrome. This study reviewed the prevalence of the metabolic syndrome in pediatric central nervous system (CNS) tumor survivors treated with autologous SCT and craniospinal radiation. A prospective, cross-sectional study in pediatric CNS tumor patients, who underwent a one-time evaluation at least 18 months post-autologous SCT for the presence of components of metabolic syndrome: obesity, hypertension, hyperlipidemia, and abnormal glucose levels. Twelve patients were evaluated, and two (16%) met full criteria for the metabolic syndrome. Seven patients (58%) had at least one component of metabolic syndrome: elevated glucose levels in 8% (1/12), obesity 17% (2/12), hypertriglyceridemia 17% (2/12), and reduced HDL cholesterol in 25% (3/12). None had hypertension. Nine patients (75%) demonstrated abnormal fasting lipid profiles with elevated total cholesterol levels, although only 25% (3/12) fulfilled criteria for a diagnosis of dyslipidemia. Pediatric CNS tumor survivors treated with autologous SCT and craniospinal radiation are at risk for early signs of metabolic syndrome, most commonly hyperlipidemia. Further studies evaluating the progression of these early signs to full criteria for the metabolic syndrome diagnosis are required.
Identifiants
pubmed: 33205297
doi: 10.1007/s00381-020-04971-2
pii: 10.1007/s00381-020-04971-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1087-1094Références
Han JW, Kwon SY, Won SC, Shin YJ, Ko JH, Lyu CJ (2009) Comprehensive clinical follow-up of late effects in childhood cancer survivors shows the need for early and well-timed intervention. Ann Oncol 20:1170–1177. https://doi.org/10.1093/annonc/mdn778
doi: 10.1093/annonc/mdn778
pubmed: 19270031
Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, Friedman DL, Marina N, Hobbie W, Kadan-Lottick NS, Schwartz CL, Leisenring W, Robison LL, Study CCS (2006) Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 355:1572–1582. https://doi.org/10.1056/NEJMsa060185
doi: 10.1056/NEJMsa060185
pubmed: 17035650
Steffens M, Beauloye V, Brichard B, Robert A, Alexopoulou O, Vermylen C, Maiter D (2008) Endocrine and metabolic disorders in young adult survivors of childhood acute lymphoblastic leukaemia (ALL) or non-Hodgkin lymphoma (NHL). Clin Endocrinol 69:819–827. https://doi.org/10.1111/j.1365-2265.2008.03283.x
doi: 10.1111/j.1365-2265.2008.03283.x
Taskinen M, Saarinen-Pihkala UM, Hovi L, Lipsanen-Nyman M (2000) Impaired glucose tolerance and dyslipidaemia as late effects after bone-marrow transplantation in childhood. Lancet 356:993–997. https://doi.org/10.1016/S0140-6736(00)02717-3
doi: 10.1016/S0140-6736(00)02717-3
pubmed: 11041401
Gurney JG, Ness KK, Sibley SD, O'Leary M, Dengel DR, Lee JM, Youngren NM, Glasser SP, Baker KS (2006) Metabolic syndrome and growth hormone deficiency in adult survivors of childhood acute lymphoblastic leukemia. Cancer 107:1303–1312. https://doi.org/10.1002/cncr.22120
doi: 10.1002/cncr.22120
pubmed: 16894525
Oeffinger KC, Adams-Huet B, Victor RG, Church TS, Snell PG, Dunn AL, Eshelman-Kent DA, Ross R, Janiszewski PM, Turoff AJ, Brooks S, Vega GL (2009) Insulin resistance and risk factors for cardiovascular disease in young adult survivors of childhood acute lymphoblastic leukemia. J Clin Oncol 27:3698–3704. https://doi.org/10.1200/JCO.2008.19.7251
doi: 10.1200/JCO.2008.19.7251
pubmed: 19564534
pmcid: 2720083
Meacham LR, Chow EJ, Ness KK, Kamdar KY, Chen Y, Yasui Y, Oeffinger KC, Sklar CA, Robison LL, Mertens AC (2010) Cardiovascular risk factors in adult survivors of pediatric cancer--a report from the childhood cancer survivor study. Cancer Epidemiol Biomark Prev 19:170–181. https://doi.org/10.1158/1055-9965.EPI-09-0555
doi: 10.1158/1055-9965.EPI-09-0555
Heikens J, Ubbink MC, van der Pal HP, Bakker PJ, Fliers E, Smilde TJ, Kastelein JJ, Trip MD (2000) Long term survivors of childhood brain cancer have an increased risk for cardiovascular disease. Cancer 88:2116–2121
doi: 10.1002/(SICI)1097-0142(20000501)88:9<2116::AID-CNCR18>3.0.CO;2-U
Nuver J, Smit AJ, Postma A, Sleijfer DT, Gietema JA (2002) The metabolic syndrome in long-term cancer survivors, an important target for secondary preventive measures. Cancer Treat Rev 28:195–214
doi: 10.1016/S0305-7372(02)00038-5
Siviero-Miachon AA, Spinola-Castro AM, Guerra-Junior G (2008) Detection of metabolic syndrome features among childhood cancer survivors: a target to prevent disease. Vasc Health Risk Manag 4:825–836. https://doi.org/10.2147/vhrm.s2881
doi: 10.2147/vhrm.s2881
pubmed: 19065999
pmcid: 2597761
Annaloro C, Usardi P, Airaghi L, Giunta V, Forti S, Orsatti A, Baldini M, Delle Volpe A, Lambertenghi Deliliers G (2008) Prevalence of metabolic syndrome in long-term survivors of hematopoietic stem cell transplantation. Bone Marrow Transplant 41:797–804. https://doi.org/10.1038/sj.bmt.1705972
doi: 10.1038/sj.bmt.1705972
pubmed: 18195686
Talvensaari KK, Lanning M, Tapanainen P, Knip M (1996) Long-term survivors of childhood cancer have an increased risk of manifesting the metabolic syndrome. J Clin Endocrinol Metab 81:3051–3055. https://doi.org/10.1210/jcem.81.8.8768873
doi: 10.1210/jcem.81.8.8768873
pubmed: 8768873
Reaven GM (1988) Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 37:1595–1607
doi: 10.2337/diab.37.12.1595
Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT (2002) The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 288:2709–2716
doi: 10.1001/jama.288.21.2709
Cook S (2004) The metabolic syndrome: antecedent of adult cardiovascular disease in pediatrics. J Pediatr 145:427–430. https://doi.org/10.1016/j.jpeds.2004.07.021
doi: 10.1016/j.jpeds.2004.07.021
pubmed: 15480357
Lambert M, Paradis G, O'Loughlin J, Delvin EE, Hanley JA, Levy E (2004) Insulin resistance syndrome in a representative sample of children and adolescents from Quebec, Canada. Int J Obes Relat Metab Disord 28:833–841. https://doi.org/10.1038/sj.ijo.0802694
doi: 10.1038/sj.ijo.0802694
pubmed: 15170466
Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, Allen K, Lopes M, Savoye M, Morrison J, Sherwin RS, Caprio S (2004) Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 350:2362–2374. https://doi.org/10.1056/NEJMoa031049
doi: 10.1056/NEJMoa031049
pubmed: 15175438
Grundy SM, Brewer HB, Cleeman JI, Smith SC, Lenfant C, Association AH, National Heart Ln, and Blood Institute (2004) Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 109:433–438. https://doi.org/10.1161/01.CIR.0000111245.75752.C6
doi: 10.1161/01.CIR.0000111245.75752.C6
pubmed: 14744958
Kero AE, Madanat-Harjuoja LM, Järvelä LS, Malila N, Matomäki J, Lähteenmäki PM (2016) Health conditions associated with metabolic syndrome after cancer at a young age: a nationwide register-based study. Cancer Epidemiol 41:42–49. https://doi.org/10.1016/j.canep.2016.01.009
doi: 10.1016/j.canep.2016.01.009
pubmed: 26816350
Majhail NS, Flowers ME, Ness KK, Jagasia M, Carpenter PA, Arora M, Arai S, Johnston L, Martin PJ, Baker KS, Lee SJ, Burns LJ (2009) High prevalence of metabolic syndrome after allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 43:49–54. https://doi.org/10.1038/bmt.2008.263
doi: 10.1038/bmt.2008.263
pubmed: 18724397
Finkelstein-Shechter T, Gassas A, Mabbott D, Huang A, Bartels U, Tabori U, Janzen L, Laura J, Hawkins C, Taylor M, Bouffet E (2010) Atypical teratoid or rhabdoid tumors: improved outcome with high-dose chemotherapy. J Pediatr Hematol Oncol 32:e182–e186. https://doi.org/10.1097/MPH.0b013e3181dce1a2
doi: 10.1097/MPH.0b013e3181dce1a2
pubmed: 20495479
Bouffet E (2010) The role of myeloablative chemotherapy with autologous hematopoietic cell rescue in central nervous system germ cell tumors. Pediatr Blood Cancer 54:644–646. https://doi.org/10.1002/pbc.22376
doi: 10.1002/pbc.22376
pubmed: 20146220
Gurney JG, Kadan-Lottick NS, Packer RJ, Neglia JP, Sklar CA, Punyko JA, Stovall M, Yasui Y, Nicholson HS, Wolden S, McNeil DE, Mertens AC, Robison LL, Study CCS (2003) Endocrine and cardiovascular late effects among adult survivors of childhood brain tumors: Childhood Cancer Survivor Study. Cancer 97:663–673. https://doi.org/10.1002/cncr.11095
doi: 10.1002/cncr.11095
pubmed: 12548609
Zimmet P, Alberti KG, Kaufman F, Tajima N, Silink M, Arslanian S, Wong G, Bennett P, Shaw J, Caprio S, Group IC (2007) The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes 8:299–306. https://doi.org/10.1111/j.1399-5448.2007.00271.x
doi: 10.1111/j.1399-5448.2007.00271.x
pubmed: 17850473
Brabant G, von zur Mühlen A, Wüster C, Ranke MB, Kratzsch J, Kiess W, Ketelslegers JM, Wilhelmsen L, Hulthén L, Saller B, Mattsson A, Wilde J, Schemer R, Kann P, Board GK (2003) Serum insulin-like growth factor I reference values for an automated chemiluminescence immunoassay system: results from a multicenter study. Horm Res 60:53–60. https://doi.org/10.1159/000071871
doi: 10.1159/000071871
pubmed: 12876414
Keskin M, Kurtoglu S, Kendirci M, Atabek ME, Yazici C (2005) Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics 115:e500–e503. https://doi.org/10.1542/peds.2004-1921
doi: 10.1542/peds.2004-1921
pubmed: 15741351
Falkner B, Daniels SR (2004) Summary of the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Hypertension 44:387–388. https://doi.org/10.1161/01.HYP.0000143545.54637.af
doi: 10.1161/01.HYP.0000143545.54637.af
pubmed: 15353515
Adolescents NHBPEPWGoHBPiCa (2004) The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics 114:555–576
doi: 10.1542/peds.114.2.S2.555
Committee. DCCPGE (2018) Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada, Can J Diabetes, pp S1-S325
Fischer C, Petriccione M, Donzelli M, Pottenger E (2016) Improving care in pediatric neuro-oncology patients: an overview of the unique needs of children with brain tumors. J Child Neurol 31:488–505. https://doi.org/10.1177/0883073815597756
doi: 10.1177/0883073815597756
pubmed: 26245798
Geyer JR, Sposto R, Jennings M, Boyett JM, Axtell RA, Breiger D, Broxson E, Donahue B, Finlay JL, Goldwein JW, Heier LA, Johnson D, Mazewski C, Miller DC, Packer R, Puccetti D, Radcliffe J, Tao ML, Shiminski-Maher T, Group CsC (2005) Multiagent chemotherapy and deferred radiotherapy in infants with malignant brain tumors: a report from the Children’s Cancer Group. J Clin Oncol 23:7621–7631. https://doi.org/10.1200/JCO.2005.09.095
doi: 10.1200/JCO.2005.09.095
pubmed: 16234523
Duffner PK, Horowitz ME, Krischer JP, Friedman HS, Burger PC, Cohen ME, Sanford RA, Mulhern RK, James HE, Freeman CR (1993) Postoperative chemotherapy and delayed radiation in children less than three years of age with malignant brain tumors. N Engl J Med 328:1725–1731. https://doi.org/10.1056/NEJM199306173282401
doi: 10.1056/NEJM199306173282401
pubmed: 8388548
Grundy RG, Wilne SH, Robinson KJ, Ironside JW, Cox T, Chong WK, Michalski A, Campbell RH, Bailey CC, Thorp N, Pizer B, Punt J, Walker DA, Ellison DW, Machin D, Committee CCLGUBT (2010) Primary postoperative chemotherapy without radiotherapy for treatment of brain tumours other than ependymoma in children under 3 years: results of the first UKCCSG/SIOP CNS 9204 trial. Eur J Cancer 46:120–133. https://doi.org/10.1016/j.ejca.2009.09.013
doi: 10.1016/j.ejca.2009.09.013
pubmed: 19818598
Cohen BH, Geyer JR, Miller DC, Curran JG, Zhou T, Holmes E, Ingles SA, Dunkel IJ, Hilden J, Packer RJ, Pollack IF, Gajjar A, Finlay JL, Group CsO (2015) Pilot study of intensive chemotherapy with peripheral hematopoietic cell support for children less than 3 years of age with malignant brain tumors, the CCG-99703 phase I/II study. A report from the Children’s Oncology Group. Pediatr Neurol 53:31–46. https://doi.org/10.1016/j.pediatrneurol.2015.03.019
doi: 10.1016/j.pediatrneurol.2015.03.019
pubmed: 26092413
pmcid: 5166616
Dhall G, Grodman H, Ji L, Sands S, Gardner S, Dunkel IJ, McCowage GB, Diez B, Allen JC, Gopalan A, Cornelius AS, Termuhlen A, Abromowitch M, Sposto R, Finlay JL (2008) Outcome of children less than three years old at diagnosis with non-metastatic medulloblastoma treated with chemotherapy on the “Head Start” I and II protocols. Pediatr Blood Cancer 50:1169–1175. https://doi.org/10.1002/pbc.21525
doi: 10.1002/pbc.21525
pubmed: 18293379
Mason WP, Grovas A, Halpern S, Dunkel IJ, Garvin J, Heller G, Rosenblum M, Gardner S, Lyden D, Sands S, Puccetti D, Lindsley K, Merchant TE, O'Malley B, Bayer L, Petriccione MM, Allen J, Finlay JL (1998) Intensive chemotherapy and bone marrow rescue for young children with newly diagnosed malignant brain tumors. J Clin Oncol 16:210–221. https://doi.org/10.1200/JCO.1998.16.1.210
doi: 10.1200/JCO.1998.16.1.210
pubmed: 9440745
Fangusaro J, Finlay J, Sposto R, Ji L, Saly M, Zacharoulis S, Asgharzadeh S, Abromowitch M, Olshefski R, Halpern S, Dubowy R, Comito M, Diez B, Kellie S, Hukin J, Rosenblum M, Dunkel I, Miller DC, Allen J, Gardner S (2008) Intensive chemotherapy followed by consolidative myeloablative chemotherapy with autologous hematopoietic cell rescue (AuHCR) in young children with newly diagnosed supratentorial primitive neuroectodermal tumors (sPNETs): report of the Head Start I and II experience. Pediatr Blood Cancer 50:312–318. https://doi.org/10.1002/pbc.21307
doi: 10.1002/pbc.21307
pubmed: 17668858
Fangusaro JR, Jubran RF, Allen J, Gardner S, Dunkel IJ, Rosenblum M, Atlas MP, Gonzalez-Gomez I, Miller D, Finlay JL (2008) Brainstem primitive neuroectodermal tumors (bstPNET): results of treatment with intensive induction chemotherapy followed by consolidative chemotherapy with autologous hematopoietic cell rescue. Pediatr Blood Cancer 50:715–717. https://doi.org/10.1002/pbc.21032
doi: 10.1002/pbc.21032
pubmed: 17009232
Gardner SL, Asgharzadeh S, Green A, Horn B, McCowage G, Finlay J (2008) Intensive induction chemotherapy followed by high dose chemotherapy with autologous hematopoietic progenitor cell rescue in young children newly diagnosed with central nervous system atypical teratoid rhabdoid tumors. Pediatr Blood Cancer 51:235–240. https://doi.org/10.1002/pbc.21578
doi: 10.1002/pbc.21578
pubmed: 18381756
Saha A, Salley CG, Saigal P, Rolnitzky L, Goldberg J, Scott S, Olshefski R, Hukin J, Sands SA, Finlay J, Gardner SL (2014) Late effects in survivors of childhood CNS tumors treated on Head Start I and II protocols. Pediatr Blood Cancer 61:1644–1652; quiz 1653-1672. https://doi.org/10.1002/pbc.25064
doi: 10.1002/pbc.25064
pubmed: 24789527
pmcid: 4714700
Armstrong GT, Liu Q, Yasui Y, Huang S, Ness KK, Leisenring W, Hudson MM, Donaldson SS, King AA, Stovall M, Krull KR, Robison LL, Packer RJ (2009) Long-term outcomes among adult survivors of childhood central nervous system malignancies in the Childhood Cancer Survivor Study. J Natl Cancer Inst 101:946–958. https://doi.org/10.1093/jnci/djp148
doi: 10.1093/jnci/djp148
pubmed: 19535780
pmcid: 2704230
Nieder ML, McDonald GB, Kida A, Hingorani S, Armenian SH, Cooke KR, Pulsipher MA, Baker KS (2011) National Cancer Institute-National Heart, Lung and Blood Institute/pediatric Blood and Marrow Transplant Consortium First International Consensus Conference on late effects after pediatric hematopoietic cell transplantation: long-term organ damage and dysfunction. Biol Blood Marrow Transplant 17:1573–1584. https://doi.org/10.1016/j.bbmt.2011.09.013
doi: 10.1016/j.bbmt.2011.09.013
pubmed: 21963877
pmcid: 3215762
Pietilä S, Mäkipernaa A, Sievänen H, Koivisto AM, Wigren T, Lenko HL (2009) Obesity and metabolic changes are common in young childhood brain tumor survivors. Pediatr Blood Cancer 52:853–859. https://doi.org/10.1002/pbc.21936
doi: 10.1002/pbc.21936
pubmed: 19165891
Cooksey R, Wu SY, Klesse L, Oden JD, Bland RE, Hodges JC, Gargan L, Vega GL, Bowers DC (2019) Metabolic syndrome is a sequela of radiation exposure in hypothalamic obesity among survivors of childhood brain tumors. J Investig Med 67:295–302. https://doi.org/10.1136/jim-2018-000911
doi: 10.1136/jim-2018-000911
pubmed: 30530528
Oeffinger KC, Mertens AC, Sklar CA, Yasui Y, Fears T, Stovall M, Vik TA, Inskip PD, Robison LL, Study CCS (2003) Obesity in adult survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study. J Clin Oncol 21:1359–1365. https://doi.org/10.1200/JCO.2003.06.131
doi: 10.1200/JCO.2003.06.131
pubmed: 12663727
Kawamoto R, Tabara Y, Kohara K, Miki T, Kusunoki T, Takayama S, Abe M, Katoh T, Ohtsuka N (2011) Relationships between lipid profiles and metabolic syndrome, insulin resistance and serum high molecular adiponectin in Japanese community-dwelling adults. Lipids Health Dis 10:79. https://doi.org/10.1186/1476-511X-10-79
doi: 10.1186/1476-511X-10-79
pubmed: 21586120
pmcid: 3118370
Lorini R, Cortona L, Scaramuzza A, De Stefano P, Locatelli F, Bonetti F, Severi F (1995) Hyperinsulinemia in children and adolescents after bone marrow transplantation. Bone Marrow Transplant 15:873–877
pubmed: 7581084
Taskinen M, Lipsanen-Nyman M, Tiitinen A, Hovi L, Saarinen-Pihkala UM (2007) Insufficient growth hormone secretion is associated with metabolic syndrome after allogeneic stem cell transplantation in childhood. J Pediatr Hematol Oncol 29:529–534. https://doi.org/10.1097/MPH.0b013e3180f61b67
doi: 10.1097/MPH.0b013e3180f61b67
pubmed: 17762493
Johannsson G, Bengtsson BA (1999) Growth hormone and the metabolic syndrome. J Endocrinol Investig 22:41–46
Roos A, Bakker SJ, Links TP, Gans RO, Wolffenbuttel BH (2007) Thyroid function is associated with components of the metabolic syndrome in euthyroid subjects. J Clin Endocrinol Metab 92:491–496. https://doi.org/10.1210/jc.2006-1718
doi: 10.1210/jc.2006-1718
pubmed: 17090642
Sanders JE, Hoffmeister PA, Woolfrey AE, Carpenter PA, Storer BE, Storb RF, Appelbaum FR (2009) Thyroid function following hematopoietic cell transplantation in children: 30 years’ experience. Blood 113:306–308. https://doi.org/10.1182/blood-2008-08-173005
doi: 10.1182/blood-2008-08-173005
pubmed: 18838614
pmcid: 2615647
Mercado G, Adelstein DJ, Saxton JP, Secic M, Larto MA, Lavertu P (2001) Hypothyroidism: a frequent event after radiotherapy and after radiotherapy with chemotherapy for patients with head and neck carcinoma. Cancer 92:2892–2897. https://doi.org/10.1002/1097-0142(20011201)92:11<2892::aid-cncr10134>3.0.co;2-t
Schmiegelow M, Lassen S, Poulsen HS, Schmiegelow K, Hertz H, Andersson AM, Skakkebaek NE, Müller J (2001) Gonadal status in male survivors following childhood brain tumors. J Clin Endocrinol Metab 86:2446–2452. https://doi.org/10.1210/jcem.86.6.7544
doi: 10.1210/jcem.86.6.7544
pubmed: 11397837
Socié G, Stone JV, Wingard JR, Weisdorf D, Henslee-Downey PJ, Bredeson C, Cahn JY, Passweg JR, Rowlings PA, Schouten HC, Kolb HJ, Klein JP (1999) Long-term survival and late deaths after allogeneic bone marrow transplantation. Late Effects Working Committee of the International Bone Marrow Transplant Registry. N Engl J Med 341:14–21. https://doi.org/10.1056/NEJM199907013410103
doi: 10.1056/NEJM199907013410103
pubmed: 10387937