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Sarcopenic obesity common in acute lymphoblastic leukemia survivors

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February 9, 2018

Long-term survivors of acute lymphoblastic leukemia frequently experience sarcopenic obesity, which affects their overall health-related quality of life, according to researchers in Canada.

“Many [survivors of ALL] experience long-term adverse sequelae (late effects) of their disease and its treatment, Ronald D. Barr, MB, ChB, MD, professor of pediatrics and pathology and medicine at McMaster University in Ontario, and colleagues wrote. “In the case of ALL, these effects include alterations in body composition (notably obesity) that carry a burden of morbidity and mortality. Much less attention has been paid to the loss of lean body mass and especially its major component, skeletal muscle mass, which leads to sarcopenia [among] patients with cancer and contributes to the phenomenon of frailty that has been described in young adult survivors of ALL.”

The researchers performed a cross-sectional study of 75 patients who had survived more than 10 years after being diagnosed with ALL. The researchers measured body composition with dual-energy x-ray absorptiometry, as well as measured fat mass, lean body mass and whole-body bone mineral content. Barr and colleagues used the Health Utilities Index  to measure health-related quality of life.

Patients’ total fat mass, lean body mass and whole-body bone mineral content matched their total body weight when added together (r = .998). Their total appendicular lean mass — which consists of the lean body mass from all four of patients’ limbs — constituted 75% of their skeletal muscle mass.

Overall, 12% of female patients and 18% of male patients were obese as measured by WHO criteria. Patients had a median fat mass index z-score of 0.4, and a median appendicular lean mass index z-score of –0.4.

Thirty-two patients (43%) had sarcopenic obesity.

Patients who had sarcopenic obesity had significantly worse health-related quality of life compared with those who did not, specifically in the areas of sensation and emotion and hearing, emotion and cognition on the Health Utilities Index.

The researchers acknowledged that the study was limited because there is no consensus on a definition of sarcopenic obesity, and because a significant number of patients treated for ALL had not attended a follow-up clinic, which opened the possibility that patients who did not participate in the study may have been healthier than those who did.

“Although a cross-sectional design has its limitations, it does provide a snapshot of prevalence,” Barr and colleagues wrote. “Clearly, this population of adolescents and young adults must be re-evaluated as they age because [fat mass] increases and [lean body mass] decreases in older adult life.” – by Andy Polhamus

Disclosures: The authors report no relevant financial disclosures.