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Guner Ozenen G, Aksoylar S, Goksen D, Gozmen S, Darcan S, Ozek G, Kansoy S. Metabolic syndrome and risk factors after hematopoietic stem cell transplantation in children and adolescents. J Pediatr Endocrinol Metab 2021; 34:485-493. [PMID: 33639046 DOI: 10.1515/jpem-2020-0584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 01/25/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The early and late complications after hematopoietic stem cell transplantation (HSCT) determine the patients' prognosis and life quality. We aim to determine the metabolic syndrome development frequency after HSCT in children to find out the risk factors and compare them with healthy adolescents. METHODS Thirty-six children who underwent HSCT at least two years ago were analyzed prospectively and cross-sectionally. Our study included 18 healthy children between the ages of 11 and 17 as a control group. All of the cases were assessed in terms of metabolic syndrome (MS) through the use of Modified WHO Criteria. RESULTS The patients' median age was 10.6 (5.1-17) years, the median time of follow-up after HCST was 4.1 (2-13.5) years and 70% were male. Two cases were diagnosed with MS (5.6%). When considered in terms of the sub-components of MS, 2 cases (5.6%) were found to have obesity, 17 cases (47%) abnormal glucose tolerance, 11 cases (30.7%) dyslipidemia, and 3 cases (8.6%) hypertension. The MS rate was not different when compared with the 11-17 year-old healthy control group (0 vs. 11%, p=0.48). Myeloablative conditioning regimen (65 vs. 20%) and the increased age at which HSCT was performed were considered to be risk factors in terms of insulin resistance (p=0.025 and 0.002). CONCLUSIONS Age and conditioning regimens were found to be the risk factors for insulin resistance development. The long-term follow-up of the cases who had undergone HSCT in childhood in terms of MS and its sub-components is important in order to increase life quality.
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Affiliation(s)
- Gizem Guner Ozenen
- Department of Pediatrics, Medical School of Ege University, Izmir, Turkey
| | - Serap Aksoylar
- Department of Pediatric Hematology & Oncology and Bone Marrow Transplantation, Medical School of Ege University, Izmir, Turkey
| | - Damla Goksen
- Department of Pediatric Endocrinology and Diabetes, Medical School of Ege University, Izmir, Turkey
| | - Salih Gozmen
- Department of Pediatric Hematology & Oncology and Bone Marrow Transplantation, Medical School of Ege University, Izmir, Turkey
| | - Sukran Darcan
- Department of Pediatric Endocrinology and Diabetes, Medical School of Ege University, Izmir, Turkey
| | - Gulcihan Ozek
- Department of Pediatric Hematology & Oncology and Bone Marrow Transplantation, Medical School of Ege University, Izmir, Turkey
| | - Savas Kansoy
- Department of Pediatric Hematology & Oncology and Bone Marrow Transplantation, Medical School of Ege University, Izmir, Turkey
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2
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Jabbour J, Manana B, Zahreddine A, Saade C, Charafeddine M, Bazarbachi A, Blaise D, El-Cheikh J. Sarcopenic obesity derived from PET/CT predicts mortality in lymphoma patients undergoing hematopoietic stem cell transplantation. Curr Res Transl Med 2018; 67:93-99. [PMID: 30583985 DOI: 10.1016/j.retram.2018.12.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 11/07/2018] [Accepted: 12/15/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Sarcopenic Obesity (SO) is associated with worse survival among chemotherapy recipients. Research on SO is scarce among lymphoma patients receiving Hematopoietic Stem Cell Transplantation (HSCT). AIM assess prevalence of SO pre-HSCT (T0) and 3 months post-HSCT (T1) in lymphoma patients and determine the power of SO at T0 and T1 in predicting survival. METHODS Consecutive patients (age ≥16 years) having B and T cell lymphoma who underwent SCT and who had PET/CT scan pre-SCT and 3 months post SCT were included in the study. A cross sectional image was analyzed at the level of the 3rd Lumber Vertebrae to assess body composition parameters. RESULTS 93 patients [mean age: 38 (range: 17-70 years), 52 (55.9%) males, 45 (48%) Hodgkin and 48 (52%) Non-Hodgkin lymphoma, 81 (87%) autologous and 12 (13%) allogeneic SCT)] met the inclusion criteria. From T0 to T1, Sarcopenia rates increased (27% at T0 to 38% at T1, p = 0.013), Visceral adiposity decreased (46% at T0 to 30% at T1, p = 0.03) and SO decreased (42% at T0 to 20% at T1, p < 0.01). Length of stay, overall survival and progression free survival were significantly better in patients without sarcopenic obesity at T1. Cox-regression revealed SO at T1 was a risk factor for mortality [Adjusted Hazards Ratio = 8.2 (95% Confidence Interval: 1.9-36.2)]. CONCLUSION Sarcopenic obesity, prevalent in 42% of patients pre-HSCT, decreased 3 months post HSCT as lymphoma patients lost skeletal muscle and visceral adipose tissues. SO at T1 was the most impactful risk factor for mortality.
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Affiliation(s)
- J Jabbour
- Department of Clinical Nutrition, American University of Beirut Medical Center, Beirut, Lebanon; Doctoral School of Life Sciences and Health, Aix Marseille Université, Marseille, France
| | - B Manana
- Division of Hematology/Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - A Zahreddine
- Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - C Saade
- Department of Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - M Charafeddine
- Division of Hematology/Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - A Bazarbachi
- Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - D Blaise
- Hematology Department, Transplantation Unit, Paoli Calmettes Institute, Marseille, France; Centre de Recherche sur le Cancer de Marseille (CRCM), Inserm U 1068, Marseille, France
| | - J El-Cheikh
- Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
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3
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Prospective evaluation of metabolic syndrome and its features in a single-center series of hematopoietic stem cell transplantation recipients. Ann Hematol 2018; 97:2471-2478. [PMID: 30054704 DOI: 10.1007/s00277-018-3452-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 07/19/2018] [Indexed: 02/01/2023]
Abstract
Available studies on metabolic syndrome (MS) after hematopoietic stem cell transplantation (HSCT) are retrospective with heterogeneous inclusion criteria, and little is known about the early post-transplant phase. In our prospective study, clinical and laboratory data were collected in 100 HSCT recipients, 48 allogeneic and 52 autologous, at baseline, at + 30, + 100 and + 360 days. At baseline, MS was observed in 24 patients, significantly associated with insulin resistance and leptin on multivariate analysis. At + 30, the diagnosis of MS was confirmed in 43 patients, significantly related to insulin resistance and allogeneic transplants. If the whole series was considered, patients with MS had significantly higher mortality from any cause. The baseline presence of any MS feature was a predictor of + 30 MS. Isolated occurrences of MS features were related to hyperleptinemia and hyperinsulinemia, except in the case of low HDL cholesterol, linked to adiponectin and resistin. Our data confirm that patients undergoing HSCT have a high prevalence of MS, with hyperleptinemia playing a major role. The early peak of new MS cases is primarily attributable to insulin resistance, notably but not exclusively immunosuppression-induced; the subsequent long-term increase in MS cases may be an effect of persistent adipokine imbalance.
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4
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Howden EJ, La Gerche A, Arthur JF, McMullen JR, Jennings GL, Dunstan DW, Owen N, Avery S, Kingwell BA. Standing up to the cardiometabolic consequences of hematological cancers. Blood Rev 2018; 32:349-360. [PMID: 29496356 DOI: 10.1016/j.blre.2018.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 12/06/2017] [Accepted: 02/20/2018] [Indexed: 12/18/2022]
Abstract
Hematological cancer survivors are highly vulnerable to cardiometabolic complications impacting long-term health status, quality of life and survival. Elevated risk of diabetes and cardiovascular disease arises not only from the effects of the cancers themselves, but also from the toxic effects of cancer therapies, and deconditioning arising from reduced physical activity levels. Regular physical activity can circumvent or reverse adverse effects on the heart, skeletal muscle, vasculature and blood cells, through a combination of systemic and molecular mechanisms. We review the link between hematological cancers and cardiometabolic risk with a focus on adult survivors, including the contributing mechanisms and discuss the potential for physical activity interventions, which may act to oppose the negative effects of both physical deconditioning and therapies (conventional and targeted) on metabolic and growth signaling (kinase) pathways in the heart and beyond. In this context, we focus particularly on strategies targeting reducing and breaking up sedentary time and provide recommendations for future research.
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Affiliation(s)
- Erin J Howden
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia.
| | - André La Gerche
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia.
| | - Jane F Arthur
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia
| | - Julie R McMullen
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia.
| | - Garry L Jennings
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia; Sydney Medical School, University of Sydney, NSW, Australia.
| | - David W Dunstan
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia.
| | - Neville Owen
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia.
| | - Sharon Avery
- Malignant Hematology and Stem Cell Transplantation Service, The Alfred Hospital, 55 Commercial Road, Melbourne, VIC, Australia.
| | - Bronwyn A Kingwell
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia.
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5
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Abstract
BACKGROUND The steep rise in thyroid cancer observed in recent decades has caused an increase in the population of long-term thyroid cancer survivors. Other than recurrences of cancer, the long-term health consequences of surviving thyroid cancer, particularly metabolic syndrome, have not yet been determined. The aim of this study was to estimate the risk of metabolic syndrome in thyroid cancer survivors. MATERIALS AND METHODS Population-based data from the Korean National Health and Nutrition Examination Survey (KNHANES) were used for the analysis. The data of KNHANES IV-VI from 2007-2014 were obtained. After excluding subjects who were under 19 years old, whose fasting interval was less than 8 hours, and whose data for predefined variables including metabolic syndrome components were incomplete, 34,347 subjects were analyzed. The incidence of metabolic syndrome and its components were evaluated in three groups: subjects with no history of thyroid cancer, subjects diagnosed with thyroid cancer within 3 years of the survey date, and subjects diagnosed more than 3 years before the survey date. RESULTS Thyroid cancer diagnoses were made within 3 years of the survey date for 95 subjects (group 1, short-term survivors) and more than 3 years earlier than the survey date for 60 subjects (group 2, long-term survivors). Metabolic syndrome was frequently observed with clinical significance (odds ratio [OR] 1.986 [95% confidence interval [CI] 1.0-3.70], p = 0.030) in short-term survivors compared with subjects with no thyroid cancer history. Risks for having high blood pressure and high fasting glucose were estimated to be higher in the short-term survivor group (OR 2.115 [CI 1.23-3.64], p = 0.006 and OR 1.792 [CI 1.03-3.11], p = 0.038, respectively). No significant associations were noticed in the long-term survivor group when compared with the group with no thyroid cancer history. CONCLUSION Risks for metabolic syndrome, especially high blood pressure and high fasting glucose, were increased in short-term survivors of thyroid cancer but not in long-term survivors when compared with subjects with no history of thyroid cancer.
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Affiliation(s)
- Min-Hee Kim
- 1 Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea
| | - Jin-Young Huh
- 2 Clinical Research Coordinating Center, Institute of Biomedical Industry Annex to Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea
| | - Dong-Jun Lim
- 1 Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea
| | - Moo-Il Kang
- 1 Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea
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DeFilipp Z, Duarte RF, Snowden JA, Majhail NS, Greenfield DM, Miranda JL, Arat M, Baker KS, Burns LJ, Duncan CN, Gilleece M, Hale GA, Hamadani M, Hamilton BK, Hogan WJ, Hsu JW, Inamoto Y, Kamble RT, Lupo-Stanghellini MT, Malone AK, McCarthy P, Mohty M, Norkin M, Paplham P, Ramanathan M, Richart JM, Salooja N, Schouten HC, Schoemans H, Seber A, Steinberg A, Wirk BM, Wood WA, Battiwalla M, Flowers MED, Savani BN, Shaw BE. Metabolic syndrome and cardiovascular disease following hematopoietic cell transplantation: screening and preventive practice recommendations from CIBMTR and EBMT. Bone Marrow Transplant 2016; 52:173-182. [PMID: 27548466 DOI: 10.1038/bmt.2016.203] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 05/08/2016] [Accepted: 05/09/2016] [Indexed: 12/12/2022]
Abstract
Metabolic syndrome (MetS) is a constellation of cardiovascular risk factors that increases the risk of cardiovascular disease, diabetes mellitus and all cause mortality. Long-term survivors of hematopoietic cell transplantation (HCT) have a substantial risk of developing MetS and cardiovascular disease, with the estimated prevalence of MetS being 31-49% among HCT recipients. Although MetS has not yet been proven to impact cardiovascular risk after HCT, an understanding of the incidence and risk factors for MetS in HCT recipients can provide the foundation to evaluate screening guidelines and develop interventions that may mitigate cardiovascular-related mortality. A working group was established through the Center for International Blood and Marrow Transplant Research and the European Group for Blood and Marrow Transplantation with the goal of reviewing literature and recommend practices appropriate to HCT recipients. Here we deliver consensus recommendations to help clinicians provide screening and preventive care for MetS and cardiovascular disease among HCT recipients. All HCT survivors should be advised of the risks of MetS and encouraged to undergo recommended screening based on their predisposition and ongoing risk factors.
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Affiliation(s)
- Z DeFilipp
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - R F Duarte
- Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - J A Snowden
- Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust and Department of Oncology & Metabolism, University of Sheffield, Sheffield, UK
| | - N S Majhail
- Department of Hematology and Oncology, Cleveland Clinic, Cleveland, OH, USA
| | - D M Greenfield
- Specialized Cancer Services, Sheffield Teaching Hospital NHS Foundation Trust, Shefflied, UK
| | - J L Miranda
- Department of Medicine, Reina Sofia University Hospital, Maimonides Institute for Biomedical Research at Cordoba (IMIBIC), University of Cordoba, CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Cordoba, Spain
| | - M Arat
- Florence Nightingale Sisli Hospital, Hematopoietic Stem Cell Transplantation Unit, Istanbul, Turkey
| | - K S Baker
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - L J Burns
- National Marrow Donor Program, University of Minnesota, Minneapolis, MN, USA
| | - C N Duncan
- Pediatric Stem Cell Transplant, Dana-Farber Cancer Institute, Boston, MA, USA
| | - M Gilleece
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - G A Hale
- All Children's Hospital, John Hopkins Medicine, St. Petersburg, FL, USA
| | - M Hamadani
- Department of Medicine, Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee, WI, USA
| | - B K Hamilton
- Department of Hematology and Oncology, Cleveland Clinic, Cleveland, OH, USA
| | - W J Hogan
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - J W Hsu
- Division of Hematology & Oncology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Y Inamoto
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - R T Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX, USA
| | - M T Lupo-Stanghellini
- Hematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milano, Italy
| | - A K Malone
- Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - P McCarthy
- Department of Medicine, Roswell Park Cancer Institute, BMT Program, Buffalo, NY, USA
| | - M Mohty
- University Pierre & Marie Curie, Paris, France.,Hopital Saint-Antoine, AP-HP, Paris, France.,INSERM UMRs 938, Paris, France
| | - M Norkin
- Division of Hematology & Oncology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - P Paplham
- Department of Medicine, Roswell Park Cancer Institute, BMT Program, Buffalo, NY, USA
| | - M Ramanathan
- Department Hematology, Oncology and Bone Marrow Transplant, UMass Memorial Medical Center, Worcester, MA, USA
| | - J M Richart
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Saint Louis University, St. Louis, MO, USA
| | | | - H C Schouten
- Maastricht University Medical Center, Maastricht, The Netherlands
| | - H Schoemans
- Department of Hematology, University Hospital Leuven and KU Leuven, Leuven, Belgium
| | - A Seber
- Hospital Samaritano, Sao Paulo, Brazil.,Associação da Medula Ossea - AMEO, Sao Paulo, Brazil
| | - A Steinberg
- Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - B M Wirk
- Department of Internal Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA
| | - W A Wood
- Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - M Battiwalla
- Hematology Branch, National Institutes of Health, Bethesda, MD, USA
| | - M E D Flowers
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - B N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - B E Shaw
- Department of Medicine, Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee, WI, USA
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7
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DeFilipp Z, Duarte RF, Snowden JA, Majhail NS, Greenfield DM, Miranda JL, Arat M, Baker KS, Burns LJ, Duncan CN, Gilleece M, Hale GA, Hamadani M, Hamilton BK, Hogan WJ, Hsu JW, Inamoto Y, Kamble RT, Lupo-Stanghellini MT, Malone AK, McCarthy P, Mohty M, Norkin M, Paplham P, Ramanathan M, Richart JM, Salooja N, Schouten HC, Schoemans H, Seber A, Steinberg A, Wirk BM, Wood WA, Battiwalla M, Flowers MED, Savani BN, Shaw BE. Metabolic Syndrome and Cardiovascular Disease after Hematopoietic Cell Transplantation: Screening and Preventive Practice Recommendations from the CIBMTR and EBMT. Biol Blood Marrow Transplant 2016; 22:1493-1503. [PMID: 27184625 PMCID: PMC4949101 DOI: 10.1016/j.bbmt.2016.05.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 05/05/2016] [Indexed: 12/22/2022]
Abstract
Metabolic syndrome (MetS) is a constellation of cardiovascular risk factors that increases the risk of cardiovascular disease, diabetes mellitus, and all cause mortality. Long-term survivors of hematopoietic cell transplantation (HCT) have a substantial risk of developing MetS and cardiovascular disease, with the estimated prevalence of MetS being 31–49% amongst HCT recipients. While MetS has not yet been proven to impact cardiovascular risk after HCT, an understanding of the incidence and risk factors for MetS in HCT recipients can provide the foundation to evaluate screening guidelines and develop interventions that may mitigate cardiovascular-related mortality. A working group was established through the Center for International Blood and Marrow Transplant Research and the European Group for Blood and Marrow Transplantation with the goal to review literature and recommend practices appropriate to HCT recipients. Here we deliver consensus recommendations to help clinicians provide screening and preventive care for MetS and cardiovascular disease among HCT recipients. All HCT survivors should be advised of the risks of MetS and encouraged to undergo recommended screening based on their predisposition and ongoing risk factors.
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Affiliation(s)
- Zachariah DeFilipp
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Rafael F Duarte
- Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - John A Snowden
- Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust and Department of Oncology & Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Navneet S Majhail
- Department of Hematology and Oncology, Cleveland Clinic, Cleveland, Ohio
| | - Diana M Greenfield
- Specialized Cancer Services, Sheffield Teaching Hospital NHS Foundation Trust, Shefflied, United Kingdom
| | - José López Miranda
- Department of Medicine, Reina Sofia University Hospital, Maimonides Institute for Biomedical Research at Cordoba (IMIBIC), University of Cordoba, CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Spain
| | - Mutlu Arat
- Florence Nightingale Sisli Hospital, Hematopoietic Stem Cell Transplantation Unit, Istanbul, Turkey
| | - K Scott Baker
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Linda J Burns
- National Marrow Donor Program, University of Minnesota, Minneapolis, Minnesota
| | - Christine N Duncan
- Pediatric Stem Cell Transplant, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Maria Gilleece
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Gregory A Hale
- All Children's Hospital, John Hopkins Medicine, St. Petersburg, Florida
| | - Mehdi Hamadani
- Center for International Blood and Marrow Transplant Research (CIBMTR), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Betty K Hamilton
- Department of Hematology and Oncology, Cleveland Clinic, Cleveland, Ohio
| | - William J Hogan
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Jack W Hsu
- Division of Hematology & Oncology, Department of Medicine, University of Florida, Gainesville, Florida
| | - Yoshihiro Inamoto
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Rammurti T Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas
| | | | - Adriana K Malone
- Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Philip McCarthy
- Roswell Park Cancer Institute, BMT Program, Department of Medicine, Buffalo, New York
| | - Mohamad Mohty
- University Pierre & Marie Curie, Paris, France; Hopital Saint-Antoine, AP-HP, Paris, France; INSERM UMRs 938, Paris, France
| | - Maxim Norkin
- Division of Hematology & Oncology, Department of Medicine, University of Florida, Gainesville, Florida
| | - Pamela Paplham
- Roswell Park Cancer Institute, BMT Program, Department of Medicine, Buffalo, New York
| | - Muthalagu Ramanathan
- Department Hematology, Oncology and Bone Marrow Transplant, UMass Memorial Medical Center, Worcester, Massachusetts
| | - John M Richart
- Saint Louis University, Department of Internal Medicine, Division of Hematology and Medical Oncology, St. Louis, Missouri
| | | | - Harry C Schouten
- Maastricht University Medical Center, Maastricht, The Netherlands
| | - Helene Schoemans
- Department of Hematology, University Hospital Leuven and KU Leuven, Leuven, Belgium
| | - Adriana Seber
- Hospital Samaritano, Sao Paulo, Brazil; Associação da Medula Ossea - AMEO, Sao Paulo, Brazil
| | - Amir Steinberg
- Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Baldeep M Wirk
- Department of Internal Medicine, Stony Brook University Medical Center, Stony Brook, New York
| | - William A Wood
- Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina
| | - Minoo Battiwalla
- Hematology Branch, National Institutes of Health, Bethesda, Maryland
| | - Mary E D Flowers
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Bronwen E Shaw
- Center for International Blood and Marrow Transplant Research (CIBMTR), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
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8
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Turcotte LM, Yingst A, Verneris MR. Metabolic Syndrome after Hematopoietic Cell Transplantation: At the Intersection of Treatment Toxicity and Immune Dysfunction. Biol Blood Marrow Transplant 2016; 22:1159-1166. [PMID: 27013015 DOI: 10.1016/j.bbmt.2016.03.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 03/14/2016] [Indexed: 12/15/2022]
Abstract
Hematopoietic cell transplantation (HCT) survivors face a multitude of short- and long-term health complications in the years after treatment. One important health complication that is associated with significant morbidity is metabolic syndrome (MetSyn). This constellation of findings, which includes obesity, glucose and lipid dysmetabolism, and hypertension, places affected individuals at increased risk for type 2 diabetes mellitus, cardiovascular complications, and stroke. Previous studies have linked MetSyn in HCT survivors to prior treatment; however, few studies have addressed the potential roles of systemic inflammation and immune system dysfunction after HCT. Within this review, we address the recent advances in the understanding of adipose tissue biology, immune, and inflammatory mechanisms involved in MetSyn in non-HCT patients, and lastly, we discuss potential novel mechanisms that may play a role in MetSyn development after HCT, such as hematopoietic stem cell source, inflammatory status of the stem cell donor, and microbiome composition, all of which represent potential new directions for post-HCT MetSyn research.
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Affiliation(s)
- Lucie M Turcotte
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota.
| | - Ashley Yingst
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Michael R Verneris
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
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