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Altered body composition in male long-term survivors of paediatric allogeneic haematopoietic stem cell transplantation: impact of conditioning regimen, chronic graft-versus-host disease and hypogonadism

Bone Marrow Transplantation volume 56, pages 457–460 (2021)Cite this article

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Abstract

Changes in body composition related to metabolic syndrome are frequent among survivors of haematopoietic stem cell transplantation (HSCT), but insights into predisposing factors are incomplete, and it is unknown to what degree these changes persist at long term. We cross-sectionally investigated body composition by dual-energy X-ray absorptiometry in 98 male survivors of paediatric allogeneic HSCT. Median (range) age at follow-up was 28.1 (18.5–47.0) years and median (range) time from transplant was 18.3 (7.7–34.6) years. Lean Body Mass Index and Skeletal Muscle Mass Index were lower in patients compared to the reference population (mean (SD) standard deviation score (SDS) –1.29 (0.99), p < 0.001 and –1.20 (1.03), p < 0.001). Fat Mass Index was comparable to the reference population, but android/gynoid (AG) fat ratio SDS was higher (mean (SD) 0.46 (1.28), p < 0.001). These changes were found in patients treated with total body irradiation (TBI) as well as non-TBI regimens, although most pronounced in the former. Further, low lean mass was associated with chronic graft-versus-host disease, while high AG ratio was associated with lower testosterone levels. Since the combination of low lean mass and high AG ratio increases the risk of cardio-metabolic disease, these health issues should be monitored at long-term clinical follow-up after paediatric HSCT.

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Acknowledgements

This study was financially supported by Rigshospitalet’s Research Funds (Denmark), The Danish Childhood Cancer Foundation, The Danish Cancer Society, The Dagmar Marshall’s Foundation (Denmark), The Hartmann Brothers’ Foundation (Denmark), The Danish Cancer Research Foundation, The Finnish Cancer Society, The Finnish Foundation of Paediatric Research, Helsinki University Research Foundation (Finland), The Swedish Childhood Cancer Foundation and The Swedish Research Council.

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Authors and Affiliations

  1. Department of Paediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    Malene Mejdahl Nielsen, Sidsel Mathiesen, Kaspar Sørensen, Marianne Ifversen & Klaus Müller

  2. Division of Haematology-Oncology and Stem Cell Transplantation, Children’s Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland

    Anu Suominen & Kirsi Jahnukainen

  3. Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark

    Christian Mølgaard

  4. Paediatric Nutrition Unit, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    Christian Mølgaard

  5. Department of Paediatrics and Adolescent Medicine, Turku University Hospital and Turku University, Turku, Finland

    Päivi M. Lähteenmäki

  6. Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    Anders Juul

  7. Paediatric Endocrinology Unit, Department of Women’s and Children’s Health, Karolinska Institutet and University Hospital, Stockholm, Sweden

    Kirsi Jahnukainen

  8. Institute for Inflammation Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    Klaus Müller

  9. Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

    Klaus Müller

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  1. Malene Mejdahl Nielsen
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Correspondence to Klaus Müller.

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Mejdahl Nielsen, M., Mathiesen, S., Suominen, A. et al. Altered body composition in male long-term survivors of paediatric allogeneic haematopoietic stem cell transplantation: impact of conditioning regimen, chronic graft-versus-host disease and hypogonadism. Bone Marrow Transplant 56, 457–460 (2021). https://doi.org/10.1038/s41409-020-01038-3

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  • DOI: https://doi.org/10.1038/s41409-020-01038-3

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