Abdominal Obesity and Cardiovascular Risk Factors in Women Who Survived Cancer or a Related Illness Following Total Body Irradiation and Stem Cell Transplant

Completed

Conditions: Hodgkin's Lymphoma
Leukemia
Non-Hodgkin's Lymphoma
Myelodysplastic Syndrome

Brief Summary: The purpose of this study is to better understand why some women who survived cancer or a related illness later develop diabetes, problems with their cholesterol, or other problems that may lead to heart disease. Because these problems may be related to treatment with total body irradiation and a stem cell transplant, the investigators will compare the rates of obesity, cholesterol problems, and diabetes between women who were treated with total body irradiation and a stem cell transplant and women who were not.

The amount and location of fat stores in the abdomen is more important than overall weight or total body fat in the development of diabetes and cholesterol problems. In general, fat can be stored in several areas in the abdomen: around the organs (visceral fat), under the skin (subcutaneous fat), and in the liver (liver fat). People with higher amounts of fat around the organs (visceral fat), even those with a normal weight, are more likely to become diabetic or have high cholesterol. The amount of fat in each of these areas can be measured with an abdominal magnetic resonance imaging (MRI).

In this study, the investigators will use blood tests, height, weight, waist circumference, blood pressure measurements, and an abdominal MRI to evaluate for several risk factors of heart disease, including cholesterol problems, diabetes and pre-diabetes, elevated blood pressure, and increased abdominal fat.

Detailed Description: We will enroll 60 female participants in this study. From the population of interest, female cancer survivors (or women treated for a related illness) who were treated with TBI prior to a SCT, we will enroll 30 participants, 10 from each of the following cancer groups: acute lymphoblastic leukemia, acute myeloid leukemia, and chronic myeloid leukemia. We are interested in determining the outcomes in adult survivors who have completed their growth by the time of study and yet are younger than the age when most women generally begin to develop insulin resistance or dyslipidemia in the general population. For this reason, we will enroll women who are 18 - 49 years of age at the time of study.

Recruitment & Eligibility

Inclusion Criteria

Target population

Females 18 - 49 years of age at time of study
Previous diagnosis of ALL, AML, CML, CLL, Hodgkin's lymphoma, Non-hodgkin's lymphoma, aplastic anemia, and myelodysplastic syndrome
Previously treated with TBI (1200 - 1500 cGy) prior to SCT
Free of cancer
Two years or more from completion of cancer therapy
Able and willing to give informed consent

Comparison group

Females 18 - 49 years of age at time of study
Previous diagnosis of ALL, AML, CML CLL, Hodgkin's lymphoma, Non-hodgkin's lymphoma, aplastic anemia, and myelodysplastic syndrome
Free of cancer
Two years or more from completion of cancer therapy
Able and willing to give informed consent

Exclusion Criteria

Target population

Pregnant at time of study
Previous cranial radiotherapy (other than TBI)
Second primary malignancy (other than non-melanoma skin cancer)
Any patient who has received glucocorticoids or tacrolimus within 60 days prior to the study
Currently on a medication for diabetes mellitus or dyslipidemia
Patients with a creatinine > 1.5 mg/dL or biopsy-proven chronic active hepatitis
Contraindication to an MRI

Comparison group

pregnant at time of study
Previous cranial radiotherapy
Second primary malignancy (other than non-melanoma skin cancer)
Any patient who has received glucocorticoids or tacrolimus within 60 days prior to the study
Currently on a medication for diabetes mellitus or dyslipidemia
Patients with a creatinine > 1.5 or biopsy-proven chronic active hepatitis
Contraindication to an MRI

Arm && Interventions

Group	Intervention	Description
Women treated with SCT/TBI	Questionnaires, Laboratory tests, Abdominal MRI	-
1:1 Matched group of women	Questionnaires, Laboratory tests, Abdominal MRI	Current age + or - 2 years Race and ethnicity Cancer diagnosis Interval from completion of cancer therapy to study + or - 2 years

Primary Outcome Measures

Name	Time	Method
Explore whether visceral adipose tissue is significantly higher in women who were treated with total body irradiation (TBI) plus stem cell transplant in comparison with women who were not	within 12 months

Secondary Outcome Measures

Name	Time	Method
To begin to characterize the psychosocial risk factors of the TBI plus stem cell transplant group, in relation to the comparison group, in order to inform a future targeted intervention to reduce risk.	within 12 months
Determine the differences in processes of changes, decisional balance for physical activity, body image, mood, and quality of life between the groups	within 12 months
Determine the correlation between the amount of visceral adipose tissue and fasting levels of triglycerides, LDL, HDL, insulin, glucose, and HOMA-IR in both groups.	within 12 months

Locations (1): Memorial Sloan Kettering Cancer Center
🇺🇸
New York, New York, United States