Cranial radiotherapy predisposes to abdominal adiposity in survivors of childhood acute lymphocytic leukemia

Abstract

Purpose: Advances in treatment of acute lymphocytic leukemia increased the likelihood of developing late treatment-associated effects, such as abdominal adiposity, which plays a key role because it increases the risk of cardiovascular disease in this population. Cranial radiotherapy is one of the factors that might be involved in this process. The aim of this study was to determine the effect of cranial radiotherapy on adiposity indexes in survivors of acute lymphocytic leukemia. Patients and Methods: A cross-sectional analysis of 56 acute lymphocytic leukemia survivors (mean age of 18.6 years, 44.6% of whom received cranial radiotherapy, 8.5 years post-treatment) who were assessed according to total body-fat and computed tomography scan-derived abdominal adipose tissue. Results: Survivors who received cranial radiotherapy showed a significant higher prevalence of obesity based on dual energy X-ray absorptiometry measurements. Additionally, cranial radiotherapy increased abdominal adipose tissue. No association was observed between cranial radiotherapy and body mass index, waist circumference or waist-to-height ratio. Female gender significantly increased body-fat. Conclusions: Adolescent and young-adult survivors of childhood acute lymphocytic leukemia showed an increase in body-fat and an alteration of fat distribution, which were both related to cranial radiotherapy. Fat compartment modifications possibly indicate a disease of adipose tissue, and cranial radiotherapy imports in this process. (AU)