TY - JOUR

T1 - Body composition after allogeneic haematopoietic cell transplantation/total body irradiation in children and young people

T2 - a restricted systematic review

AU - Lorenc, Ava

AU - Hamilton-Shield, Julian

AU - Perry, Rachel

AU - Stevens, Michael

AU - Wotton, Steve

AU - Feelisch, Martin

AU - Dragsted, Lars Ove

AU - Dicks, Marlou

AU - Shoaie, Saed

AU - Mardinoglu, Adil

AU - Roche, Helen

AU - on behalf of the CTYA HSCT Adipose and Muscle Late Effects Working Group

N1 - CURIS 2020 NEXS 153

PY - 2020

Y1 - 2020

N2 - 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 haematopoietic 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 as follows: leukaemia, HSCT+TBI, aged ≤ 24 years at HSCT and 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 are 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 utilizing nutritional manipulation and/or targeted activity, should be investigated.

AB - 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 haematopoietic 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 as follows: leukaemia, HSCT+TBI, aged ≤ 24 years at HSCT and 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 are 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 utilizing nutritional manipulation and/or targeted activity, should be investigated.

KW - Adipose tissue

KW - Leukaemia

KW - Lipodystrophy

KW - Sarcopenia

KW - Stem cell transplantation

UR - http://www.scopus.com/inward/record.url?scp=85084350545&partnerID=8YFLogxK

U2 - 10.1007/s11764-020-00871-1

DO - 10.1007/s11764-020-00871-1

M3 - Review

C2 - 32388841

AN - SCOPUS:85084350545

VL - 14

SP - 624

EP - 642

JO - Journal of Cancer Survivorship

JF - Journal of Cancer Survivorship

SN - 1932-2259

IS - 5

ER -