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Huot JR, Jamnick NA, Pin F, Livingston PD, Callaway CS, Bonetto A. GL261 glioblastoma induces delayed body weight gain and stunted skeletal muscle growth in young mice. Am J Physiol Regul Integr Comp Physiol 2025; 328:R628-R641. [PMID: 40247678 DOI: 10.1152/ajpregu.00035.2025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2025] [Revised: 02/26/2025] [Accepted: 04/07/2025] [Indexed: 04/19/2025]
Abstract
The survival rate for children and adolescents has increased to over 85%. However, there is limited understanding of the impact of pediatric cancers on muscle development and physiology. Given that brain tumors alone account for 26% of all pediatric cancers, this study aimed to investigate the skeletal muscle consequences of tumor growth in young mice. C2C12 myotubes were cocultured with GL261 murine glioblastoma cells to assess myotube size. GL261 cells were then injected subcutaneously into 4-wk-old male C57BL/6J mice. Animals were euthanized 28 days post-GL261 implantation. Muscle function was tested in vivo and ex vivo. Muscle protein synthesis was estimated via the SUnSET method, and gene/protein expression levels were assessed via Western blotting and qPCR. In vitro, the C2C12 cultures exposed to GL261 exhibited myotube atrophy, consistent with a disrupted anabolic/catabolic balance. In vivo, carcass, heart, and fat mass were significantly reduced in the tumor-bearing mice. Skeletal muscle growth was impeded in the GL261 hosts, along with a smaller muscle cross-sectional area (CSA). Both in vivo muscle torque and the ex vivo Extensor Digitorum Longus (EDL) muscle force were unchanged. At molecular level, the tumor hosts displayed reduced estimations of muscle protein synthesis and increased muscle protein ubiquitination, in disagreement with decreased muscle ubiquitin ligase mRNA expression. Overall, we showed that GL261 tumors impact the growth of pediatric mice by stunting skeletal muscle development, decreasing muscle mass, reducing muscle fiber size, diminishing muscle protein synthesis, and altering protein catabolism signaling.NEW & NOTEWORTHY This study shows that pediatric brain tumors stunt muscle development in young mice. GL261 glioblastoma cells caused myotube atrophy, reduced carcass, heart, and fat mass, and impeded skeletal muscle growth. Tumor-bearing mice had decreased muscle protein synthesis and increased protein ubiquitination. This is the first demonstration that GL261 tumors reduce muscle mass and fiber size, impair muscle function and innervation, and alter muscle protein turnover.
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Affiliation(s)
- Joshua R Huot
- Department of Anatomy, Cell Biology and Physiology, Indiana University School of Medicine, Indianapolis, Indiana, United States
- Department of Kinesiology, School of Health and Human Sciences, Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States
| | - Nicholas A Jamnick
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Fabrizio Pin
- Department of Anatomy, Cell Biology and Physiology, Indiana University School of Medicine, Indianapolis, Indiana, United States
| | - Patrick D Livingston
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Chandler S Callaway
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Andrea Bonetto
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Nutrition Obesity Research Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Comprehensive Cancer Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
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Guzmán-León AE, Gallegos-Castorena S, Romo-Rubio H, Casillas-Toral E, Lopez-Teros V, Stein K. Nutritional status at diagnosis and its relationship with survival and relapse in Mexican children with acute lymphoblastic leukemia: a retrospective study. BMC Cancer 2025; 25:325. [PMID: 39984931 PMCID: PMC11846316 DOI: 10.1186/s12885-025-13729-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2024] [Accepted: 02/13/2025] [Indexed: 02/23/2025] Open
Abstract
BACKGROUND & AIMS Childhood acute lymphoblastic leukemia (ALL) is a malignancy with varying survival rates across countries with low, middle, and high income. The assessment of nutritional status (NS) using anthropometric indicators has been explored for its potential relationship on treatment outcomes. This study analyzed a 3-year retrospective cohort of Mexican pediatric patients with ALL, exploring the association between NS at diagnosis and relapse/mortality. METHODS Retrospective observational study. Medical records from 252 pediatric patients with ALL were included; anthropometric indicators (Z-scores) of body weight, height, mid-upper arm circumference (MUAC), and triceps and subscapular skinfolds (TSF and SSF, respectively) measurements were used to assess NS. The relapse/mortality data were collected from medical records. Kaplan-Meier (KM) functions and Cox regression models were performed to evaluate the effect of indicators on survival, relapse, and event (death or disease relapse). RESULTS Patients with malnutrition showed a significantly lower survival rate according to their BMI (76% vs 63%, p = 0.049), while relapses were higher in the group with TSF < -2 SD (41% vs 12%, p = 0.007). Patients with stunting and TSF < -2 SD showed a higher risk of mortality (HR:6.214, 95%CI: 1.372 to 28.154; HR:2.91, 95%CI: 1.27 to 6.68, respectively), while in patients with higher MUAC Z-score showed a decrease in the mortality risk (HR:0.85, 95%CI:0.73 to 1.00). CONCLUSIONS The nutritional status assessed by anthropometric measurements was a strong predictor of survival and relapse outcomes 3y post/diagnosis in this cohort of pediatric patients with ALL.
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Affiliation(s)
- Alan E Guzmán-León
- Department of Chemical and Biological Sciences, Universidad de Sonora, Hermosillo, Sonora, Mexico
| | - Sergio Gallegos-Castorena
- Pediatric Hemato-Oncology Service, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico
| | - Hugo Romo-Rubio
- Pediatric Hemato-Oncology Service, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico
| | | | - Veronica Lopez-Teros
- Department of Chemical and Biological Sciences, Universidad de Sonora, Hermosillo, Sonora, Mexico
| | - Katja Stein
- Pediatric Hemato-Oncology Service, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico.
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Salvador Quevedo y Zubieta 750, Independencia Oriente, Guadalajara, Jalisco, 44360, Mexico.
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Huot JR, Jamnick NA, Pin F, Livingston PD, Callaway CS, Bonetto A. GL261 glioblastoma induces delayed body weight gain and stunted skeletal muscle growth in young mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2025:2025.02.10.635159. [PMID: 39990490 PMCID: PMC11844426 DOI: 10.1101/2025.02.10.635159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2025]
Abstract
Introduction The survival rate for children and adolescents has increased to over 85%. However, there is limited understanding of the impact of pediatric cancers on muscle development and physiology. Given that brain tumors alone account for 26% of all pediatric cancers, this study aimed to investigate the skeletal muscle consequences of tumor growth in young mice. Methods C2C12 myotubes were co-cultured with GL261 murine glioblastoma cells to assess myotube size. GL261 cells were then injected subcutaneously into 4-week-old male C57BL/6J mice. Animals were euthanized 28 days post-GL261 implantation. Muscle function was tested in vivo and ex vivo . Muscle protein synthesis was measured via the SUnSET method, and gene/protein expression levels were assessed via Western blotting and qPCR. Results In vitro , the C2C12 cultures exposed to GL261 exhibited myotube atrophy, consistent with a disrupted anabolic/catabolic balance. In vivo , carcass, heart, and fat mass were significantly reduced in the tumor-bearing mice. Skeletal muscle growth was impeded in the GL261 hosts, along with smaller muscle CSA. Both in vivo muscle torque and the ex vivo EDL muscle force were unchanged. At molecular level, the tumor hosts displayed reduced muscle protein synthesis and increased muscle protein ubiquitination, in disagreement with decreased muscle ubiquitin ligase mRNA expression. Conclusions Overall, we showed that GL261 tumors impact the growth of pediatric mice by stunting skeletal muscle development, decreasing muscle mass, reducing muscle fiber size, diminishing muscle protein synthesis, and altering protein catabolism signaling.
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Lovell AL, Gardiner B, Henry L, Bate JM, Brougham MFH, Iniesta RR. The evolution of nutritional care in children and young people with acute lymphoblastic leukaemia: a narrative review. J Hum Nutr Diet 2025; 38:e13273. [PMID: 38185902 PMCID: PMC11589404 DOI: 10.1111/jhn.13273] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 12/08/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Acute lymphoblastic leukaemia (ALL) is the most common paediatric malignancy in the world. Advances in treatment protocols have resulted in survival rates of >80% in most high-income countries (HIC); however, children and young people (CYP) with ALL continue to face significant nutrition-related challenges during treatment. METHODS This narrative review outlines the changing landscape of treatment and survivorship for CYP with ALL and the advances in nutrition knowledge that call for changes to clinical nutrition practice. RESULTS The incidence of ALL has remained stable in HIC; however, there have been significant advances in survival over the past 30 years. Overweight and obesity are increasingly prevalent in CYP with ALL at diagnosis, during treatment and in survivorship. Coupled with poor diet quality, high-energy and saturated fat intakes, altered eating behaviours and inactivity, this necessitates the need for a shift in nutrition intervention. Undernutrition remains a concern for CYP with high-risk treatment protocols where oral or enteral nutrition support remains a cornerstone of maintaining nutrition status. CONCLUSIONS With improved treatment protocols and high survival rates, a shift to focusing on diet quality, prevention of excessive weight gain and obesity during treatment and survivorship is necessary.
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Affiliation(s)
- Amy L. Lovell
- Department of Nutrition and Dietetics, The University of AucklandFaculty of Medical and Health SciencesAucklandNew Zealand
- Starship Blood and Cancer CentreStarship Child HealthAucklandNew Zealand
| | - Breeana Gardiner
- Department of Nutrition and DieteticsGreat Ormond Street Hospital NHS Foundation TrustLondonUK
| | - Louise Henry
- Department of Nutrition and DieteticsRoyal Marsden NHS Foundation TrustSurreyUK
| | - Jessica M. Bate
- Department of Paediatric OncologySouthampton Children's HospitalSouthamptonUK
| | - Mark F. H. Brougham
- Department of Haematology and OncologyRoyal Hospital for Sick ChildrenEdinburghUK
| | - Raquel Revuelta Iniesta
- Children's Health and Exercise Research Centre (CHERC), Faculty of Health and Life Sciences, Public Health and Sport Sciences, Medical School, St Luke's CampusUniversity of ExeterExeterUK
- Child Life and HealthUniversity of EdinburghEdinburghUK
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Guzmán-León AE, Avila-Prado J, Bracamontes-Picos LR, Haby MM, Stein K, Astiazaran-Garcia H, Lopez-Teros V. Nutritional interventions in children with acute lymphoblastic leukemia undergoing antineoplastic treatment: a systematic review. BMC Nutr 2024; 10:89. [PMID: 38898513 PMCID: PMC11186292 DOI: 10.1186/s40795-024-00892-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND A compromised nutritional status jeopardizes a positive prognosis in acute lymphoblastic leukemia (ALL) patients. In low- and middle-income countries, ~ 50% of children with ALL are malnourished at diagnosis time, and undergoing antineoplastic treatment increases the risk of depleting their nutrient stores. Nutrition interventions are implemented in patients with cancer related malnutrition. We aimed to evaluate the effect of nutrition interventions in children diagnosed with ALL under treatment. METHODS Using a predefined protocol, we searched for published or unpublished randomized controlled trials in: Cochrane CENTRAL, MEDLINE, EMBASE, LILACS, and SciELO, and conducted complementary searches. Studies where at least 50% of participants had an ALL diagnosis in children ≤ 18 years, active antineoplastic treatment, and a nutrition intervention were included. Study selection and data extraction were conducted independently by three reviewers, and assessment of the risk of bias by two reviewers. Results were synthesized in both tabular format and narratively. RESULTS Twenty-five studies (out of 4097 records) satisfied the inclusion requirements. There was a high risk of bias in eighteen studies. Interventions analyzed were classified by compound/food (n = 14), micronutrient (n = 8), and nutritional support (n = 3). Within each group the interventions and components (dose and time) tested were heterogeneous. In relation to our primary outcomes, none of the studies reported fat-free mass as an outcome. Inflammatory and metabolic markers related to nutritional status and anthropometric measurements were reported in many studies but varied greatly across the studies. For our secondary outcomes, fat mass or total body water were not reported as an outcome in any of the studies. However, some different adverse events were reported in some studies. CONCLUSIONS This review highlights the need to conduct high-quality randomized controlled trials for nutrition interventions in children with ALL, based on their limited number and heterogeneous outcomes. REGISTRATION OF THE REVIEW PROTOCOL Guzmán-León AE, Lopez-Teros V, Avila-Prado J, Bracamontes-Picos L, Haby MM, Stein K. Protocol for a Systematic Review: Nutritional interventions in children with acute lymphoblastic leukemia undergoing an tineoplastic treatment. International prospective register of systematic reviews. 2021; PROSPERO CRD:42,021,266,761 ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=266761 ).
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Affiliation(s)
- Alan E Guzmán-León
- Department of Chemical and Biological Sciences, Universidad de Sonora, Blvd. Luis Encinas y Rosales S/N, Hermosillo , 83000, Sonora, Mexico
| | - Jessica Avila-Prado
- Department of Chemical and Biological Sciences, Universidad de Sonora, Blvd. Luis Encinas y Rosales S/N, Hermosillo , 83000, Sonora, Mexico
| | - Leslie R Bracamontes-Picos
- Department of Chemical and Biological Sciences, Universidad de Sonora, Blvd. Luis Encinas y Rosales S/N, Hermosillo , 83000, Sonora, Mexico
| | - Michelle M Haby
- Department of Chemical and Biological Sciences, Universidad de Sonora, Blvd. Luis Encinas y Rosales S/N, Hermosillo , 83000, Sonora, Mexico.
- School of Population and Global Health, Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia.
| | - Katja Stein
- Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Centro Universitario de Ciencias de La Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Humberto Astiazaran-Garcia
- Department of Chemical and Biological Sciences, Universidad de Sonora, Blvd. Luis Encinas y Rosales S/N, Hermosillo , 83000, Sonora, Mexico
- Research Center for Food and Development (CIAD), Sonora, Mexico
| | - Veronica Lopez-Teros
- Department of Chemical and Biological Sciences, Universidad de Sonora, Blvd. Luis Encinas y Rosales S/N, Hermosillo , 83000, Sonora, Mexico.
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Schab M, Skoczen S. Nutritional status, body composition and diet quality in children with cancer. Front Oncol 2024; 14:1389657. [PMID: 38706604 PMCID: PMC11066172 DOI: 10.3389/fonc.2024.1389657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/02/2024] [Indexed: 05/07/2024] Open
Abstract
During cancer treatment, nutritional status disorders such as malnutrition or obesity affect the tolerance of cancer treatment, quality of life, but also the pharmacokinetics of drugs. It is hypothesized that changes in fat and lean body mass can modify chemotherapy volume distribution, metabolism and clearance. In children with cancer, lean body mass decreases or remains low during treatment and fat mass increases. Body composition is influenced by the cancer itself, aggressive multimodal-therapies, changes in metabolism, unbalanced diet and reduced physical activity. Due to the side effects of treatment, including changes in the sense of taste and smell, nausea, vomiting, diarrhea, and stress, eating according to recommendation for macronutrients and micronutrients is difficult. Research indicates that throughout cancer treatment, the consumption of fruits, vegetables, and dairy products tends to be insufficient, whereas there is an elevated intake of sugar and unhealthy snacks. Children exhibit a preference for high-carbohydrate, salty, and strongly flavored products. This review revealed the importance of body composition and its changes during cancer treatment in children, as well as eating habits and diet quality.
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Affiliation(s)
- Magdalena Schab
- Doctoral School of Medical and Health Science, Jagiellonian University Medical College, Krakow, Poland
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Szymon Skoczen
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
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Lin S, Yu X, Chen H, Chen Z, Yang Y. Clinical efficacy of prostate PI-RADS V2.1 score combined with serum PSA-related indicators in the detection of gray zone prostate cancer. Int Urol Nephrol 2023; 55:2685-2693. [PMID: 37523077 DOI: 10.1007/s11255-023-03692-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 06/22/2023] [Indexed: 08/01/2023]
Abstract
PURPOSE The purpose of this study is to improve the diagnostic accuracy of gray zone prostate cancer evaluation by combining the prostate imaging report and data system version 2.1 (PI-RADS V2.1) score with serum prostate-specific antigen (PSA). METHODS We analyzed data from 212 men suspected of having prostate cancer and compared PSA-related indicators and PI-RADS V2.1 scores between 96 patients with prostate cancer and 116 without prostate cancer. By contrasting PI-RADS V2.1 scores with serum PSA-related markers, the diagnostic precision in the detection of grey zone prostate cancer was assessed. RESULTS The median PI-RADS V2.1 scores and serum tPSA levels of patients with prostate cancer were significantly higher (P < 0.05). The PI-RADS V2.1 score correlated positively with serum tPSA, PSA density (PSAD), and prostate health index (PHI) levels (P < 0.05) and negatively correlated with fPSA/tPSA concentrations (P < 0.05). Logistic regression identified risk factors including family history, PI-RADS V2.1 score, tPSA, PSAD, and PHI, with prostate volume and fPSA/tPSA as protective factors (P < 0.05). Combining serum PSA-related indicators with the PI-RADS V2.1 score improved diagnostic accuracy for gray zone prostate cancer (AUC 0.986, specificity 99.14%, sensitivity 92.71%). CONCLUSION The presence of a family history, a high PI-RADS V2.1 score, and elevated serum PSA-related markers contribute to high prostate cancer risk and development. The combined use of these indicators offers superior predictive value in detecting prostate cancer compared to a single indicator.
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Affiliation(s)
| | - XiuXiu Yu
- Wenzhou Medical University, Wenzhou, China
| | | | | | - Yu Yang
- Wenzhou Medical University, Wenzhou, China.
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Prior E, Uthaya SN, Gale C. Measuring body composition in children: research and practice. Arch Dis Child Educ Pract Ed 2023:archdischild-2022-324920. [PMID: 36813541 DOI: 10.1136/archdischild-2022-324920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/14/2022] [Indexed: 02/24/2023]
Affiliation(s)
- Emily Prior
- Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College, London, UK
| | - Sabita N Uthaya
- Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College, London, UK.,Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Chris Gale
- Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College, London, UK
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Tram NK, Chou TH, Ettefagh LN, Deep K, Bobbey AJ, Audino AN, Stacy MR. Quantification of chemotherapy-induced changes in body composition in pediatric, adolescent, and young adult lymphoma using standard of care CT imaging. Eur Radiol 2022; 32:7270-7277. [PMID: 35947147 DOI: 10.1007/s00330-022-09048-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/17/2022] [Accepted: 07/13/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The objective of this study was to use computed tomography (CT) imaging to quantify chemotherapy-induced changes in body composition (BC) in pediatric, adolescent, and young adult (AYA) patients with lymphoma and to compare image-derived changes in BC measures to changes in traditional body mass index (BMI) measures. METHODS Skeletal muscle (SkM), subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT) volumes were manually segmented using low-dose CT images acquired from a 10-year retrospective, single-site cohort of 110 patients with lymphoma. CT images and BMI percentiles (BMI%) were acquired from baseline and first therapeutic follow-up. CT image segmentation was performed at vertebral level L3 using 5 consecutive axial CT images. RESULTS CT imaging detected significant treatment-induced changes in BC measures from baseline to first follow-up time points, with SAT and VAT significantly increasing and SkM significantly decreasing. BMI% measures did not change from baseline to first follow-up and were not significantly correlated with changes in image-derived BC measures. Patients who were male, younger than 12 years old, diagnosed with non-Hodgkin's lymphoma, and presented with stage 3 or 4 disease gained more adipose tissue and lost more SkM in response to the first cycle of treatment compared to their clinical counterparts. CONCLUSIONS Standard of care CT imaging can quantify treatment-induced changes in BC that are not reflected by traditional BMI assessment. Image-based monitoring of BC parameters may offer personalized approaches to lymphoma treatment for pediatric and AYA patients by guiding cancer treatment recommendations and subsequently enhance clinical outcomes. KEY POINTS • Standard of care low-dose CT imaging quantifies chemotherapy-induced changes in body composition in pediatric, adolescent, and young adults with lymphoma. • Body mass index could not detect changes in body composition during treatment that were quantified by CT imaging. • Pediatric and AYA patients who were male, younger than 12 years old, and diagnosed with non-Hodgkin's lymphoma, and presented with stage 3 or 4 disease gained more adipose tissue and lost more skeletal muscle tissue in response to the first cycle of treatment compared to their clinical counterparts.
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Affiliation(s)
- Nguyen K Tram
- Center for Regenerative Medicine, The Research Institute at Nationwide Children's Hospital, 575 Children's Crossroad, WB4131, Columbus, OH, 43215, USA
| | - Ting-Heng Chou
- Center for Regenerative Medicine, The Research Institute at Nationwide Children's Hospital, 575 Children's Crossroad, WB4131, Columbus, OH, 43215, USA
| | - Laila N Ettefagh
- Center for Regenerative Medicine, The Research Institute at Nationwide Children's Hospital, 575 Children's Crossroad, WB4131, Columbus, OH, 43215, USA
| | - Kyra Deep
- Center for Regenerative Medicine, The Research Institute at Nationwide Children's Hospital, 575 Children's Crossroad, WB4131, Columbus, OH, 43215, USA
| | - Adam J Bobbey
- Department of Radiology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Anthony N Audino
- Division of Hematology/Oncology/BMT, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Mitchel R Stacy
- Center for Regenerative Medicine, The Research Institute at Nationwide Children's Hospital, 575 Children's Crossroad, WB4131, Columbus, OH, 43215, USA.
- Division of Vascular Surgery and Diseases, Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA.
- Interdisciplinary Biophysics Graduate Program, The Ohio State University, Columbus, OH, USA.
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Goodenough CG, Partin RE, Ness KK. Skeletal Muscle and Childhood Cancer: Where are we now and where we go from here. AGING AND CANCER 2021; 2:13-35. [PMID: 34541550 PMCID: PMC8445321 DOI: 10.1002/aac2.12027] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 05/03/2021] [Indexed: 12/22/2022]
Abstract
Skeletal muscle (muscle) is essential for physical health and for metabolic integrity, with sarcopenia (progressive muscle mass loss and weakness), a pre-curser of aging and chronic disease. Loss of lean mass and muscle quality (force generation per unit of muscle) in the general population are associated with fatigue, weakness, and slowed walking speed, eventually interfering with the ability to maintain physical independence, and impacting participation in social roles and quality of life. Muscle mass and strength impairments are also documented during childhood cancer treatment, which often persist into adult survivorship, and contribute to an aging phenotype in this vulnerable population. Although several treatment exposures appear to confer increased risk for loss of mass and strength that persists after therapy, the pathophysiology responsible for poor muscle quantity and quality is not well understood in the childhood cancer survivor population. This is partly due to limited access to both pediatric and adult survivor muscle tissue samples, and to difficulties surrounding non-invasive investigative approaches for muscle assessment. Because muscle accounts for just under half of the body's mass, and is essential for movement, metabolism and metabolic health, understanding mechanisms of injury responsible for both initial and persistent dysfunction is important, and will provide a foundation for intervention. The purpose of this review is to provide an overview of the available evidence describing associations between childhood cancer, its treatment, and muscle outcomes, identifying gaps in current knowledge.
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Affiliation(s)
- Chelsea G. Goodenough
- Epidemiology and Cancer Control Department, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Robyn E. Partin
- Epidemiology and Cancer Control Department, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Kirsten K. Ness
- Epidemiology and Cancer Control Department, St. Jude Children’s Research Hospital, Memphis, TN, USA
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Gallo N, Horvath K, Czuppon K, Tomsits E, Felegyhazi E, Kovacs GT. Different nutritional screening tools and recommended screening algorithm for pediatric oncology patients. Clin Nutr 2021; 40:3836-3841. [PMID: 34130030 DOI: 10.1016/j.clnu.2021.05.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/07/2021] [Accepted: 05/15/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND & AIMS Cancer is one of the leading causes of death for children; however, appropriate nutritional status can positively affect disease progression and outcome. The aim of this study was to present our self-developed nutritional risk screening method, relate it to another validated tool and to objective bio-impedance measures. We intended to recommend a screening algorithm which can be used in our pediatric oncology facilities. METHODS We analysed data from 109 pediatric oncology patients (age 3-18) at the 2nd Department of Pediatrics, Semmelweis University between 2017 and 2018. The nutritional status was assessed by the Nutrition screening tool for childhood cancer (SCAN), Nutrition risk screening for pediatric cancer (NRS-PC) our own self-developed screening tool and Bio-impedance analysis (InBody 720 and S10). Classifier properties for low muscle mass measured by Bio-impedance analysis were compared for SCAN and NRS-PC in the overall sample and in the different phases of the disease. RESULTS The AUC of 0.67 [95% CI:0.58,0.75] of the SCAN was significantly lower (Z = -2.46, p = 0.014) than in the case of the NRS-PC (AUC = 0.75 [95% CI:0.67,0.82]), indicating that NRS-PC has better classifier properties to identify children with lower muscle mass. No significant difference was found in the different phases of the disease. CONCLUSIONS Based on our results, we suggest screening high BMI patients first with NRS-PC. However, in case of low BMI bio-impedance measures provide more precise information on muscle mass and nutritional risk. Further data are needed to decide whether the NRS-PC is sensitive enough in normal BMI patients.
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Affiliation(s)
- Nora Gallo
- 2nd Department of Pediatrics, Semmelweis University, Budapest, 1094, 7-9 Tuzolto Street, Hungary.
| | - Klara Horvath
- 2nd Department of Pediatrics, Semmelweis University, Budapest, 1094, 7-9 Tuzolto Street, Hungary
| | - Krisztina Czuppon
- 2nd Department of Pediatrics, Semmelweis University, Budapest, 1094, 7-9 Tuzolto Street, Hungary
| | - Erika Tomsits
- 2nd Department of Pediatrics, Semmelweis University, Budapest, 1094, 7-9 Tuzolto Street, Hungary
| | - Edina Felegyhazi
- 2nd Department of Pediatrics, Semmelweis University, Budapest, 1094, 7-9 Tuzolto Street, Hungary
| | - Gabor T Kovacs
- 2nd Department of Pediatrics, Semmelweis University, Budapest, 1094, 7-9 Tuzolto Street, Hungary
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