Abstract
Purpose
To collate evidence of changes in body composition following treatment of leukaemia in children, teenagers and young adults (CTYA, 0-24 years) with allogeneic hematopoietic stem cell transplant and total body irradiation (HSCT+TBI).
Methods
Papers were identified by searching Medline and Google Scholar, reference lists/citations and contacting key authors, with no date or language restrictions. Inclusion criteria were: leukaemia, HSCT+TBI, aged ≤24 years at HSCT, changes in body composition (total fat, central adiposity, adipose tissue function, muscle mass, muscle function). Quality was assessed using a brief Newcastle-Ottawa scale.
Results
Of 900 papers, 20 were included: seven controlled, five uncontrolled studies and eight case reports. Study quality appeared good. There was little evidence of differences in total fat/weight for HSCT+TBI groups (compared to healthy controls/population norms/short stature controls). There was some evidence of significantly higher central adiposity and differences in adipose tissue function (compared to leukaemic/non-leukaemic controls). Muscle mass was significantly lower (compared to healthy/obese controls). Muscle function results were inconclusive but suggested impairment. Case reports confirmed a lipodystrophic phenotype.
Conclusions
Early remodelling of adipose tissue and loss of skeletal muscle is evident following HSCT+TBI for CTYA leukaemia, with extreme phenotype of overt lipodystrophy. There is some evidence for reduced muscle effectiveness.
Implications for Cancer Survivors
Body composition changes in patients after HSCT+TBI are apparent by early adult life and link with the risk of excess cardiometabolic morbidity seen in adult survivors. Interventions to improve muscle and/or adipose function, perhaps utilising nutritional manipulation and/or targeted activity, should be investigated.
To collate evidence of changes in body composition following treatment of leukaemia in children, teenagers and young adults (CTYA, 0-24 years) with allogeneic hematopoietic stem cell transplant and total body irradiation (HSCT+TBI).
Methods
Papers were identified by searching Medline and Google Scholar, reference lists/citations and contacting key authors, with no date or language restrictions. Inclusion criteria were: leukaemia, HSCT+TBI, aged ≤24 years at HSCT, changes in body composition (total fat, central adiposity, adipose tissue function, muscle mass, muscle function). Quality was assessed using a brief Newcastle-Ottawa scale.
Results
Of 900 papers, 20 were included: seven controlled, five uncontrolled studies and eight case reports. Study quality appeared good. There was little evidence of differences in total fat/weight for HSCT+TBI groups (compared to healthy controls/population norms/short stature controls). There was some evidence of significantly higher central adiposity and differences in adipose tissue function (compared to leukaemic/non-leukaemic controls). Muscle mass was significantly lower (compared to healthy/obese controls). Muscle function results were inconclusive but suggested impairment. Case reports confirmed a lipodystrophic phenotype.
Conclusions
Early remodelling of adipose tissue and loss of skeletal muscle is evident following HSCT+TBI for CTYA leukaemia, with extreme phenotype of overt lipodystrophy. There is some evidence for reduced muscle effectiveness.
Implications for Cancer Survivors
Body composition changes in patients after HSCT+TBI are apparent by early adult life and link with the risk of excess cardiometabolic morbidity seen in adult survivors. Interventions to improve muscle and/or adipose function, perhaps utilising nutritional manipulation and/or targeted activity, should be investigated.
| Original language | English |
|---|---|
| Pages (from-to) | 624-642 |
| Number of pages | 19 |
| Journal | Journal of Cancer Survivorship |
| Volume | 14 |
| Issue number | 5 |
| Early online date | 18 Jul 2020 |
| DOIs | |
| Publication status | Published - 1 Oct 2020 |
Keywords
- Stem Cell Transplantation
- leukemia
- lipodystrophy
- sarcopenia
- adipose tissue
Access to Document
- Full-text PDF (final published version)
This is the final published version of the article (version of record). It first appeared online via Springer Nature at https://link.springer.com/article/10.1007/s11764-020-00871-1. Please refer to any applicable terms of use of the publisher.