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 - UTU Research Portal

A1 Refereed original research article in a scientific journal

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

Authors: Mejdahl Nielsen Malene, Mathiesen Sidsel, Suominen Anu, Sørensen Kaspar, Ifversen Marianne, Mølgaard Christian, Lähteenmäki Päivi M., Juul Anders, Jahnukainen Kirsi, Müller Klaus

Publisher: NATURE PUBLISHING GROUP

Publication year: 2021

Journal: Bone Marrow Transplantation

Journal name in source: BONE MARROW TRANSPLANTATION

Journal acronym: BONE MARROW TRANSPL

Volume: 56

Issue: 2

First page : 457

Last page: 460

Number of pages: 4

ISSN: 0268-3369

eISSN: 1476-5365

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

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.