Longitudinal Changes in Body Mass and Composition in Survivors of Childhood Hematologic Malignancies After Allogeneic Hematopoietic Stem-Cell Transplantation

被引:52
作者
Inaba, Hiroto [2 ]
Yang, Jie [3 ]
Kaste, Sue C. [2 ]
Hartford, Christine M.
Motosue, Megan S.
Chemaitilly, Wassim
Triplett, Brandon M. [2 ]
Shook, David R. [2 ]
Pui, Ching-Hon [2 ]
Leung, Wing [1 ,2 ]
机构
[1] St Jude Childrens Res Hosp, Dept Bone Marrow Transplantat & Cellular Therapy, Memphis, TN 38105 USA
[2] Univ Tennessee, Ctr Hlth Sci, Memphis, TN 38163 USA
[3] SUNY Stony Brook, Stony Brook, NY 11794 USA
关键词
ACUTE LYMPHOBLASTIC-LEUKEMIA; BONE-MARROW-TRANSPLANTATION; VERSUS-HOST-DISEASE; CANCER SURVIVOR; ADULT SURVIVORS; WORKING PARTY; FINAL HEIGHT; WEIGHT-LOSS; OBESITY; CHILDREN;
D O I
10.1200/JCO.2011.40.0457
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose To measure longitudinal changes in body mass and composition in survivors of childhood hematologic malignancies after allogeneic hematopoietic stem-cell transplantation (HSCT). Patients and Methods Body mass index (BMI) was analyzed in 179 survivors by category (underweight, healthy-weight, overweight, and obese) and by z score. Fat and lean body mass measured by dual-energy x-ray absorptiometry was analyzed as z scores. Results Over a median 6.6 years of follow-up, BMI z scores diminished significantly (0.32 pre-HSCT v -0.60 at 10 years post-HSCT; P < .001). Mean z scores for fat mass stayed within population norms, but those for lean mass remained below normal levels and diminished significantly over time (P = .018). Pre-HSCT BMI category and/or z score were strongly predictive of post-HSCT BMI (P < .001) and of fat and lean mass z scores (both P < .001). Survivors with extensive chronic graft-versus-host disease were more likely than others to have low BMI (P = .004) and low lean mass (P < .001) post-HSCT. Older age at HSCT (P = .015) and T-cell-depleted graft (P = .018) were predictive of lower post-HSCT BMI. Female patients had higher body fat (P = .002) and lower lean mass (P = .013) z scores than male patients, and black patients had higher fat mass z scores than white patients (P = .026). Conclusion BMI declines significantly after allogeneic HSCT for childhood hematologic malignancies, reflecting primarily a substantial decrease in lean mass but not fat mass. Monitoring and preservation of BMI and lean mass are vital, especially in those with the identified risk factors. J Clin Oncol 30:3991-3997. (C) 2012 by American Society of Clinical Oncology
引用
收藏
页码:3991 / 3997
页数:7
相关论文
共 34 条
[1]  
[Anonymous], 2007, NAT HLTH NUTR EX SUR
[2]   Long-term health-related outcomes in survivors of childhood cancer treated with HSCT versus conventional therapy: a report from the Bone Marrow Transplant Survivor Study (BMTSS) and Childhood Cancer Survivor Study (CCSS) [J].
Armenian, Saro H. ;
Sun, Can-Lan ;
Kawashima, Toana ;
Arora, Mukta ;
Leisenring, Wendy ;
Sklar, Charles A. ;
Baker, K. Scott ;
Francisco, Liton ;
Teh, Jennifer Berano ;
Mills, George ;
Wong, F. Lennie ;
Rosenthal, Joseph ;
Diller, Lisa R. ;
Hudson, Melissa M. ;
Oeffinger, Kevin C. ;
Forman, Stephen J. ;
Robison, Leslie L. ;
Bhatia, Smita .
BLOOD, 2011, 118 (05) :1413-1420
[3]   Long-term health status among survivors of childhood cancer: Does sex matter? [J].
Armstrong, Gregory T. ;
Sklar, Charles A. ;
Hudson, Melissa M. ;
Robison, Leslie L. .
JOURNAL OF CLINICAL ONCOLOGY, 2007, 25 (28) :4477-4489
[4]   Long-Term Consequences of Hematopoietic Stem Cell Transplantation: Current State of the Science [J].
Baker, K. Scott ;
Armenian, Saro ;
Bhatia, Smita .
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 2010, 16 (01) :S90-S96
[5]   Late mortality after allogeneic hematopoietic cell transplantation and functional status of long-term survivors: report from the Bone Marrow Transplant Survivor Study [J].
Bhatia, Smita ;
Francisco, Liton ;
Carter, Andrea ;
Sun, Can-Lan ;
Baker, K. Scoff ;
Gurney, James G. ;
McGlave, Philip B. ;
Nademanee, Auayporn ;
O'Donnell, Margaret ;
Ramsay, Norma K. C. ;
Robison, Leslie L. ;
Snyder, David ;
Stein, Anthony ;
Forman, Stephen J. ;
Weisdorf, Daniel J. .
BLOOD, 2007, 110 (10) :3784-3792
[6]  
Brennan BMD, 1999, CLIN ENDOCRINOL, V50, P163
[7]   Weight loss and reduced body mass index: a critical issue in children with multiorgan chronic graft-versus-host disease [J].
Browning, B ;
Thormann, K ;
Seshadri, R ;
Duerst, R ;
Kletzel, M ;
Jacobsohn, DA .
BONE MARROW TRANSPLANTATION, 2006, 37 (05) :527-533
[8]  
CHANDRA RK, 1983, LANCET, V1, P688
[9]   Final height in pediatric patients after hyperfractionated total body irradiation and stem cell transplantation [J].
Chemaitilly, W. ;
Boulad, F. ;
Heller, G. ;
Kernan, N. A. ;
Small, T. N. ;
O'Reilly, R. J. ;
Sklar, C. A. .
BONE MARROW TRANSPLANTATION, 2007, 40 (01) :29-35
[10]   INTELLECTUAL-PERFORMANCE AFTER PRESYMPTOMATIC CRANIAL RADIOTHERAPY FOR LEUKEMIA - EFFECTS OF AGE AND SEX [J].
CHRISTIE, D ;
LEIPER, AD ;
CHESSELLS, JM ;
VARGHAKHADEM, F .
ARCHIVES OF DISEASE IN CHILDHOOD, 1995, 73 (02) :136-140