The Metabolic Syndrome Among Leukemia Survivors: Physiopathological Analysis

Summary

Along with the improvement of childhood acute leukemia treatment, survival rates have increased. Therefore, the number of long term childhood leukemia survivors has increased progressively over the last decades. So, the assessment of long term health status in this population becomes very important. Many studies have shown an increased risk of life threatening late complications and early mortality. Cardiovascular morbidity and mortality are particularly frequent. Among these late complications, the metabolic syndrome (MS) is an important concern since it is associated with cardiovascular morbidity and mortality. The overall MS prevalence in the French prospective cohort of survivors of childhood acute leukemia was 9.2% and 18.6% in cases of total body irradiation (TBI) during the leukemia treatment. Since the median age at MS evaluation was 21 years, this prevalence was very high. Anyway, the MS pathophysiology in this population is still poorly understood. One of the most recent hypothesis about the MS mechanism is based on the adipose tissue inability to store fatty acids: when adipose tissue cannot expanse further to store excess nutriments then lipids accumulate in other tissues. This ectopic lipids accumulation can cause insulin resistance and MS.

The investigators hypothesized that the adipose tissue could be damaged by treatments received during childhood acute leukemia treatment (particularly TBI). This leads to morphological and functional abnormalities that could promote the insulin resistance and MS.

This ectopic adipose tissue contains less preadipocytes, which could impair its functional properties.

The primary endpoint of this study is to compare the morphological and functional characteristics of adipose tissue in patients with a MS who received or not TBI during childhood leukemia treatment . This comparison will focus on:

* The adipose tissue repartition and evaluation of the ectopic adipose tissue
* Fibrosis and inflammation of the adipose tissue
* Preadipocytes quantification

The secondary endpoint is to describe:

* for the whole cohort of included patients,
* the clinical and biological characteristics associated with the MS.
* Cardiovascular risk factors and nutritional statement
* Anthropometric measurements
* Detection of other endocrinal abnormalities possibly associated with the MS
* Analysis of inflammation blood markers and adipokines quantification.

Conditions

• Metabolic Syndrome X

Interventions

OTHER

Adipose tissu repartition

absorptiometry,

OTHER

Visceral and liver adipose tissue repartition

MRI,spectroscopy,

OTHER

Preadipocyte quantification and adipose tissue inflamation

biopsy

OTHER

Inflamation blood markers quantification

blood drawn,

Sponsors & Collaborators

• Assistance Publique Hopitaux De Marseille

  lead OTHER

Principal Investigators

• Urielle DESALBRES · AP-HM

• Claire OUDIN, MD · AP-HM

Study Design

Allocation

NON_RANDOMIZED

Purpose

DIAGNOSTIC

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2015-05-31

Primary Completion

2016-05-31

Completion

2016-12-31

Countries

• France

Study Locations