Department of Pediatrics, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
Department of Pediatrics, Yamaguchi University Hospital, Ube, Japan.
Jpn J Clin Oncol. 2021 Jul 1;51(7):1100-1106. doi: 10.1093/jjco/hyab046.
The incidence and background factors of sarcopenia and obesity in long-term survivors of childhood leukemia/lymphoma were not clear in Japan.
Between August 2018 and September 2019, we recruited adults aged ≥18 years who had childhood leukemia/lymphoma. Blood sampling, body composition measurement by bioelectrical impedance analysis and grip strength test were performed.
Among 81 adult survivors (34 men and 47 women) with a median age of 25.0 years, 9 (11%) had sarcopenia and 10 (12%) had obesity, of whom, 3 had metabolic syndrome. Sarcopenia was observed in 7 (21%) of 33 survivors with hematopoietic stem cell transplantation (HSCT) and 2 (4%) of 48 survivors without hematopoietic stem cell transplantation (P = 0.012). The incidence of obesity was significantly higher in the cranial radiotherapy (P = 0.021) and non-transplanted cases (P = 0.042). Univariate logistic regression analysis revealed that hematopoietic stem cell transplantation for sarcopenia (odds ratio, 6.19; 95% confidence interval, 1.2-32.0; P = 0.03) and cranial radiotherapy for obesity (odds ratio, 5.6; 95% confidence interval, 1.4-22.4; P = 0.015) were significantly associated. Hypertension was more prevalent among the obese survivors, and higher transaminase levels were found more in both the sarcopenia and obese survivors than in others.
Young adult survivors of childhood leukemia/lymphoma could be at risk of developing sarcopenia after hematopoietic stem cell transplantation and obesity after cranial radiotherapy. Further studies are required to assess the body composition of long-term survivors to find detailed risk factors of sarcopenia and metabolic syndrome.
日本儿童白血病/淋巴瘤长期幸存者中肌少症和肥胖的发生率及其背景因素尚不清楚。
我们于 2018 年 8 月至 2019 年 9 月招募了年龄≥18 岁的儿童白血病/淋巴瘤成年幸存者。进行了血液采样、生物电阻抗分析和握力测试来测量身体成分。
在 81 名中位年龄为 25.0 岁的成年幸存者(34 名男性和 47 名女性)中,9 名(11%)患有肌少症,10 名(12%)患有肥胖症,其中 3 名患有代谢综合征。在接受造血干细胞移植(HSCT)的 33 名幸存者中观察到 7 例(21%)肌少症,在未接受造血干细胞移植的 48 名幸存者中观察到 2 例(4%)(P=0.012)。颅放疗(P=0.021)和未移植病例(P=0.042)肥胖症的发生率显著更高。单变量 logistic 回归分析显示,肌少症的造血干细胞移植(优势比,6.19;95%置信区间,1.2-32.0;P=0.03)和肥胖症的颅放疗(优势比,5.6;95%置信区间,1.4-22.4;P=0.015)显著相关。肥胖幸存者中高血压更为常见,肌少症和肥胖幸存者的转氨酶水平均高于其他幸存者。
造血干细胞移植后儿童白血病/淋巴瘤的年轻成年幸存者可能有发生肌少症的风险,颅放疗后可能有发生肥胖症的风险。需要进一步研究来评估长期幸存者的身体成分,以找到肌少症和代谢综合征的详细危险因素。