Background: Metabolic syndrome (MS) is a long-term complication of pediatric haematopoietic stem cell transplantation (HSCT) and it was described more often in patients who were exposed to total body irradiation (TBI). Since previous studies reported discrepancy in the presence of metabolic complications in HSCT survivors who underwent chemotherapy-only conditioning, we investigated the frequency of MS in our HSCT-treated children for various disorders without being exposed to TBI in the conditioning regimen.
Material and Method: Twenty nine pediatric HSCT survivors after chemotherapy-only conditioning were compared with 16 healthy subjects matched for age and sex. MS was defined according to the criteria of Ferranti et al. Total body fat and android/gynoid (A/G) ratio were assessed by dual-energy X-ray absorptiometry (DXA) in 22 HSCT recipients.
Results: We identified only two patients (6.9%) who met at least three criteria for MS in our study, another five patients (17.2%) presented one criterion of MS while three patients (10.3%) met two criteria for MS. A waist circumference (WC) higher than percentile 75 was present in 20.7% (n=6) of HSCT survivors, high blood pressure (BP) in four patients (13.8%), glucose metabolism disorders in one patient (3.4%), while 27.5% of recipients TCSH (n=8) were diagnosed with dyslipidemia. A total of 63.63% of HSCT recipients (n=14) had an A/G ratio adjusted for age and sex higher than normal (66% of girls and 60% boys). HSCT survivors were more likely to develop high BP compared to controls (17.39% vs 0%, P=0.047). HSCT survivors who fulfilled at least 1 criteria of MS had higher mean BMI (0.13±1.54 kg/m2 vs −1.33±1.06 kg/m2, P=0.009), higher mean WC (77.90±14.57 cm vs 63.78±10.29 cm, p=0.006) and higher mean WC/height (0.5±0.07 vs 0.44±0.04, P=0.029) compared to the HSCT recipients with none of the MS criteria. Mean A/G ratio and total body fat were similar in autologous and allogeneic HSCT recipients.
Conclusion: This study demonstrates that pediatric HSCT survivors who underwent chemotherapy-only conditioning are also associated with an unfavorable metabolic profile, one third of them presenting at least one MS component.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology