在接受急性淋巴细胞白血病治疗的儿童和年轻人身体组成的变化:系统性审查和元分析
Lina A Zahed1,2, Raquel Revuelta Iniesta3, Mary Fewtrell2
1Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
Pediatric blood & cancer
|January 6, 2026
概括
患有急性淋巴细胞白血病 (ALL) 的儿童和青少年在治疗期间和治疗后经历了脂肪质量增加和减少无脂肪质量. 这些身体组成的变化持续到生存期,突出了进一步研究的需要.
科学领域:
- 儿科瘤学 儿科瘤学
- 身体组成分析 身体成分分析
- 癌症的生存率 癌症的生存率
背景情况:
- 患有急性淋巴细胞白血病 (ALL) 的儿童和年轻人 (CYP) 面临着患上sarcopenic肥胖症的风险增加.
- 身体组成的变化,包括脂肪质量增加和无脂肪质量减少,可以在ALL治疗的早期出现,并持续到生存期.
研究的目的:
- 系统地审查当前关于治疗期间和治疗后LAL的CYP体质组合变化的文献.
- 评估儿童ALL幸存者的改变身体组成的流行和持续程度.
主要方法:
- 在PROSPERO (CRD42023480732) 注册的PRISMA指南的系统审查.
- 搜索了PubMed,MEDLINE (OVID) 和CINAHL数据库,直到2024年3月,寻找涉及0-21岁的ALL个体的研究.
- 包括13项研究 (8项横截面,5项前性) 和使用Joanna Briggs Institute检查清单评估偏差风险. 使用了各种身体成分评估方法,包括DXA,BIA和ADP.
主要成果:
- 脂肪质量 (FM) 在治疗早期显著增加 (≈ +1 SDS),并在治疗后保持升高 (≈ +0.7 SDS).
- 在治疗期间,无脂肪质量 (FFM) 减少 (最低在≈-0.7 SDS),只观察到部分恢复.
- 与对照组相比,ALL组的体重指数 (BMI) 较高,在研究中存在显著的异质性.
结论:
- 这一审查证实在治疗期间和治疗后在CYP与ALL中FM和FFM的持续增加和减少.
- 方法和评估时间的显著异质性需要谨慎解释.
- 迫切需要进行大型国际研究,采用标准化的身体成分评估,以确定儿科ALL幸存者的长期风险.
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