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28.01.2020 | Ausgabe 1/2020

Cancer and Metastasis Reviews 1/2020

Bariatric interventions in obesity treatment and prevention in pediatric acute lymphoblastic leukemia: a systematic review and meta-analysis

Zeitschrift:
Cancer and Metastasis Reviews > Ausgabe 1/2020
Autoren:
Kuan-Wen Wang, Salma Ladhani, Brianna Empringham, Carol Portwine, Adam Fleming, Laura Banfield, Janatani Balakumaran, Lisa Sarpong, E. Danielle Sims, Alexander Nicholas Popa, Lehana Thabane, M. Constantine Samaan
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The online version of this article (https://​doi.​org/​10.​1007/​s10555-020-09849-y) contains supplementary material, which is available to authorized users.

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Abstract

Most children are surviving acute lymphoblastic leukemia (ALL) today. Yet, the emergence of cardiometabolic comorbidities in this population may impact long-term outcomes including the quality of life and lifespan. Obesity is a major driver of cardiometabolic disorders in the general population, and in ALL patients it is associated with increased risk of hypertension, dysglycemia, and febrile neutropenia when compared with lean ALL patients undergoing therapy. This systematic review aims to assess the current evidence for bariatric interventions to manage obesity in children with ALL. The primary outcome for this systematic review was the change in BMI z-score with implementation of the interventions studied. Literature searches were conducted in several databases. Ten publications addressing the study question were included in this review, and five studies were used in the meta-analysis to assess the impact of the bariatric interventions on obesity. The BMI z-score did not change significantly with the interventions. However, the quality of evidence was low, which precluded the recommendation of their use. In conclusion, prospective, rigorous, adequately powered, and high-quality longitudinal studies are urgently needed to deliver effective lifestyle interventions to children with ALL to treat and prevent obesity. These interventions, if successful, may improves cardiometabolic health outcomes and enhance the quality of life and life expectancy in children with ALL.

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