Early signs of metabolic syndrome in pediatric central nervous system tumor survivors after high-dose chemotherapy and a
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ORIGINAL ARTICLE
Early signs of metabolic syndrome in pediatric central nervous system tumor survivors after high-dose chemotherapy and autologous stem-cell transplantation and radiation Chantel Cacciotti 1,2,3 & Muhammad Ali 4 & Ute Bartels 4 & Jonathan D. Wasserman 5 & Erilda Kapllani 4 & Joerg Krueger 4 & Eric Bouffet 4 & Tal Schechter 4 Received: 13 July 2020 / Accepted: 11 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose 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. Methods 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. Results 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. Conclusion 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. Keywords Stem-cell transplant . The metabolic syndrome . Hypertension . Dyslipidemia . Obesity
Introduction
* Chantel Cacciotti [email protected] 1
Department of Pediatrics, McMaster Children’s Hospital, Hamilton, ON, Canada
2
Department of Pediatric Neuro-Oncology, Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, MA, USA
3
Department of Pediatric Hematology/Oncology, Western University, London Health Sciences Center, 800 Commissioners Road E, Rm B1-114, London, ON N6A 5W9, Canada
4
Division of Hematology-Oncology, Hospital for Sick Children, Toronto, ON, Canada
5
Division of Endocrinology, Hospital for Sick Children, Toronto, ON, Canada
Long-term complications that impact the quality of life and reduce life expectancy of cancer survivors are more prevalent and have an increased severity in patients treated with stem-cell transplantation (SCT) compared to those treated without SCT [1]. Over the last two decades, the use of autologous SCT in children and adolescents with cancer has increased substantially resulting in improved survival, in particular among individuals with neuroblastoma and some embryonal CNS tumors
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