Body Composition Abnormalities in Long-Term Survivors of Pediatric Hematopoietic Stem Cell Transplantation - 08/12/11
, Jill P. Ginsberg, MD 1, Nancy Bunin, MD 1, Babette S. Zemel, PhD 3, Justine Shults, PhD 5, Meena Thayu, MD, MSCE 3, Mary B. Leonard, MD, MSCE 4, 5
Reprint requests: Sogol Mostoufi-Moab, MD, MSCE, The Children’s Hospital of Philadelphia, 3535 Market St, Philadelphia, PA 19104.Abstract |
Objective |
To quantify lean mass (LM) and fat mass (FM) in survivors of childhood allogeneic hematopoietic stem-cell transplantation (alloHSCT) compared with healthy reference participants and identify risk factors for body composition abnormalities.
Study design |
Whole body LM and FM were measured with dual energy x-ray absorptiometry in 54 survivors (ages 5-25 years) and 894 healthy reference participants in a cross-sectional study. Multivariate regression models were used to compare sex- and race-specific Z-scores for LM for height (LM-Ht) and FM for height (FM-Ht) in survivors and reference participants and to identify correlates of LM-Ht and FM-Ht Z-scores in alloHSCT.
Results |
Height Z-scores were significantly lower in alloHSCT survivors (P < .001) compared with reference participants; body mass index Z-scores did not differ (P = .13). Survivors had significantly lower mean LM-Ht Z-scores (−0.72; 95% CI, −1.02-−0.42; P < .001) and greater FM-Ht Z-scores (1.10; 95% CI, 0.84-1.39; P < .001) compared with reference participants. LM-Ht Z-score deficits in alloHSCT survivors were larger (−1.26; 95% CI, −1.53-−0.99; P < .001) after adjustment for FM-Ht Z-scores. Endocrinopathies and alloHSCT characteristics were not associated with LM-Ht or FM-Ht Z-scores.
Conclusion |
Survivors of childhood alloHSCT have significant LM deficits and FM excess. Future studies should identify the mechanism and consequences of these abnormalities.
Le texte complet de cet article est disponible en PDF.Mots-clés : ALL, alloHSCT, AML, BMI, DXA, FM, FM-Ht, GH, GVHD, LM, LM-Ht, TBI
Plan
| Supported by the St. Baldrick’s Foundation, National Institutes of Health (grants R01 HD040714, R01 DK060030, and K24 DK076808), and Clinical Translational Research Center (grant UL 1-RR-024134). The authors declare no conflicts of interest. |
Vol 160 - N° 1
P. 122-128 - janvier 2012 Retour au numéro
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