Factors affecting weight and body composition in childhood cancer survivors—cross-sectional study

Abstract Background Due to improved efficacy of antitumour treatment in the general population, there are increasingly more childhood cancer survivors. However, some of these survivors are at risk of distant complications including cardiovascular disease. We aimed to examine the risk of overweight/obesity and abnormal body composition in a large group of patients from our paediatric oncology centre. Method We used anthropometric methods and electrical bioimpedance to assess these features, and then determined their association with disease and treatment. Results We found patients treated for leukaemia/lymphoma (especially boys) had significantly higher rates of overweight/obesity compared to the other patient groups. In contrast, overweight/obesity was more common in girls among patients treated for solid tumours. Patients treated for leukaemia/lymphoma were characterized by a higher body fat content compared to those treated for solid tumours and controls. During treatment for cancer patients had a higher percentage of muscle mass deficiency compared to those in the control group. Our regression analysis showed time from completion of treatment, gender, and type of therapy (radiotherapy, megachemotherapy) were associated with body weight and body composition including fat and muscle content. Conclusions We recommend pediatricians and general practitioners should actively try to detect and prevent cardiovascular disease among childhood cancer survivors.

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Health behaviors of caregivers of childhood cancer survivors: a cross-sectional study

BMC Cancer ◽

10.1186/s12885-020-06765-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

In Young Cho ◽

Nack-Gyun Chung ◽

Hee Jo Baek ◽

Ji Won Lee ◽

Ki Woong Sung ◽

...

Keyword(s):

Health Behaviors ◽

Cancer Survivors ◽

Childhood Cancer ◽

Childhood Cancer Survivors ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Bleomycin-associated lung toxicity in childhood cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.9591 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 9591-9591

Author(s):

Alexandra Patricia Zorzi ◽

Connie L Yang ◽

Sharon Dell ◽

Paul C. Nathan

Keyword(s):

Lung Function ◽

Pulmonary Function ◽

Cancer Survivors ◽

Childhood Cancer ◽

Lung Metastases ◽

Univariate Analysis ◽

Childhood Cancer Survivors ◽

Cross Sectional Study ◽

Current Recommendation ◽

Cross Sectional

9591 Background: Bleomycin has been established as a pulmonary toxin, but the risk for toxicity in survivors of childhood cancer is poorly characterized. Methods: We conducted a cross-sectional study of lung function in survivors of childhood Hodgkin lymphoma and germ cell tumor treated with bleomycin at our institution between 1997 and 2010. We assessed their most recent post-therapy pulmonary function test (PFT). Spirometry and lung volumes were categorized as normal, restrictive, obstructive or mixed. Diffusing capacity of carbon monoxide (DLCO) was categorized as normal or abnormal. Results: 195 patients were treated with bleomycin. Ten died of non-pulmonary causes. Of 185 survivors, 143 (77%) had complete data available for analysis. Median cumulative bleomycin dose was 60U/m2 (IQR 30-60). Three patients (2%) had a history of acute bleomycin toxicity. PFTs were performed a median of 2.3 years (IQR 1.4-4.9) from completion of therapy. Spirometry was abnormal in 58 patients (41%); of whom 5 (9%) had respiratory symptoms. 42 (70%) had obstructive, 11 (18%) restrictive and 5 (9%) mixed ventilatory defects. Abnormalities were mild in 53 (91%), moderate in 3 (5%) and severe in 2 (4%). DLCO was abnormal in 27 patients, 26 (96%) of whom had mildly reduced DLCO and were asymptomatic. Univariate analysis did not demonstrate a significant association between gender, smoking, lung metastases, lung radiation, chemotherapy regimen, or autologous transplant and abnormal lung function. Disease relapse was associated with abnormal lung function (p=0.01). Smoking (p=0.04) and relapse (p=0.03) were associated with abnormal DLCO. The odds ratio of developing abnormal spirometry for each 1unit/m2 increase in bleomycin was 1.01 (95% CI 1.00-1.02, p=0.07). Conclusions: Childhood cancer survivors treated with bleomycin frequently have evidence of asymptomatic abnormalities on PFT. The current recommendation for pulmonary function testing in childhood cancer survivors appears justified.

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Premature ovarian failure after childhood cancer and risk of metabolic syndrome – a cross-sectional analysis

Acta Endocrinologica ◽

10.1530/eje-20-1275 ◽

2021 ◽

Author(s):

Axel Netterlid ◽

Helena Mörse ◽

Aleksander Giwercman ◽

Emir Henic ◽

Kristina E Akesson ◽

...

Keyword(s):

Metabolic Syndrome ◽

Childhood Cancer ◽

Fasting Glucose ◽

Childhood Cancer Survivors ◽

Cross Sectional Study ◽

Sectional Study ◽

Ovarian Insufficiency ◽

Cross Sectional ◽

X Ray ◽

Sectional Analysis

Objective: Female childhood cancer survivors (CCS) are at risk of several late effects, among them metabolic syndrome (MetS) and premature ovarian insufficiency (POI). The objective is to study if POI is associated with risk of MetS and increased cardiovascular risk in CSS. Design: A cross-sectional study with a median time since cancer diagnosis of 25 (12 – 41) years. Patients and controls were recruited from the South Medical Region of Sweden. Methods: The study included 167 female CCS, median age 34 (19 – 57) years, diagnosed with childhood cancer at median age 8.4 (0.1 – 17.9) years together with 164 controls, matched for age, sex, ethnicity, residence, and smoking habits. All subjects were examined with fasting glucose, insulin, HbA1c, and lipid profile. Fat mass was calculated with dual-energy X-ray absorptiometry (DXA), questionnaires for medication were obtained. Detailed information of cancer treatment was available. Results: POI was present in 13% (22/167) among CCS (hypothalamic/pituitary cause excluded) and in none among controls. MetS was present in 14% (24/167) among all CCS (p = 0.001), in 23% (5/22) of those with POI (p < 0.001), compared with 4% (6/164) among controls. OR for MetS in all CCS compared with controls was 4.4 (95% CI 1.8, 11.1) (p = 0.002) and among CCS with POI the OR was 7.7 (CI 2.1, 28.1) (p = 0.002). Conclusion: The prevalence of MetS was higher in females treated for childhood cancer compared with controls and the presence of POI significantly increased the risk of developing MetS.

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Predictors for participation in DNA self-sampling of childhood cancer survivors in Switzerland

10.1101/2021.05.25.21257796 ◽

2021 ◽

Author(s):

Nicolas Waespe ◽

Sven Strebel ◽

Denis Marino ◽

Veneranda Mattiello ◽

Fanny Muet ◽

...

Keyword(s):

Cancer Survivors ◽

Childhood Cancer ◽

Age Groups ◽

Childhood Cancer Survivors ◽

Cross Sectional Study ◽

Cancer Predisposition ◽

Second Primary ◽

Cross Sectional ◽

Cancer Predisposition Syndrome ◽

Foreign Nationality

Research on germline genetic variants relies on a sufficient number of eligible participants which is difficult to achieve for rare diseases such as childhood cancer. With self-collection kits using saliva or buccal swabs, participants can contribute genetic samples conveniently from their home. We identified determinants of participation in DNA self-collection in this cross-sectional study. We invited 928 childhood cancer survivors in Switzerland with a median age of 26.5 years (interquartile range 18.8-36.5), of which 463 (50%) participated. Foreign nationality (odds ratio [OR] 0.5, 95%-confidence interval [CI] 0.4-0.7), survivors aged 30-39 years at study versus other age groups (OR 0.5, CI 0.4-0.8), and those with a known cancer predisposition syndrome (OR 0.5, CI 0.3-1.0) participated less. Survivors with a second primary neoplasm (OR 1.9, CI 1.0-3.8) or those living in a French or Italian speaking region (OR 1.3, 1.0-1.8) tended to participate more. We showed that half of survivors participate in germline DNA self-sampling relying completely on mailing of sample kits. Foreign nationality, age 30-39 years, and cancer predisposition syndromes were associated with less participation. More targeted recruitment strategies may be advocated for these subgroups. To increase participation in DNA self-sampling, understanding and perceptions of survivors need to be better understood.

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