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Obesity/Metabolic QuickFact

Childhood cancer survivors can be at risk for developing the following late effects:

  • Overweight/Obesity
  • Metabolic Syndrome
  • Diabetes Mellitus

If your patient does not have a Survivor Healthcare Plan (SHP), please refer him/her to the appropriate survivor clinic.

Important factors in determining risk for late effects:

  • Total dose of radiation
  • BMI
  • Family history
  • Age of patient at time of treatment
  • Endocrinopathies
  • Gender
  • Surgery in suprasellar region
  • Prolonged corticosteroid therapy

Chemotherapy

Table 1

 

Overweight/Obesity

Dyslipidemia

Diabetes Mellitus

Alkylating Agents

BCNU

Busulfan

CCNU

Chlorambucil Cyclophosphamide

   Cytoxan

Ifosphamide

Mechlorethamine

Melphalan

Procarbazine

Thiotepa

 

Dacarbazine

    DTIC

Temozolomide

 

 

 

Heavy Metals

Carboplatin

Cisplatin

 

 

 

 

 

Antimetabolites

Cytarabine

   Ara-C

Mercaptopurine

   6MP

Thioguanine

   6TG

Methotrexate

 

 

 

 

Anthracycline antibiotics

Daunorubicin

Doxorubicin

   Adriamycin

Epirubicin

Idarubicin

Mitoxantrone

 

 

 

 

Chemotherapy

Table 2

Overweight/Obesity

Dyslipidemia

Diabetes Mellitus

Anti-tumor antibiotics

Bleomycin

Dactinomycin

 

 

 

Corticosteroids

Dexamethasone

   Decadron

Prednisone

 

 

 

 

Enzymes

Asparaginase

 

 

 

 

Plant alkaloids

Vincristine

Vinblastine

 

 

 

 

Epipodophyllotoxins

Etoposide

   VP16

Teniposide

   VM26

 

 

 

 

 

Radiation

Overweight/Obesity

Dyslipidemia

Diabetes Mellitus

All Radiation

 

 

 

TBI

 

X

 

Head/Brain

X

 

 

Neck

 

 

 

Thorax

 

 

 

Abdomen

 

 

X

Pelvis

 

 

 

Extremity

 

 

 

 

Hematopoietic

Stem Cell Transplant

 

Overweight/Obesity

Hyperlipidemia

Diabetes Mellitus

Hematopoietic Stem Cell Transplant

 

 

 

Hematopoietic Stem Cell Transplant with ANY history of chronic Graft vs. Host Disease (GVHD)

 

 

 

Surgery

Overweight/Obesity

Hyperlipidemia

Diabetes Mellitus

 

Neurosurgery – Brain

X

 

 

 

 

For recommendations on how to screen for all potential late effects please refer to The Children's Oncology Group Long-term Follow-up Guidelines.

Health Links-Teaching Handouts from The Children's Oncology Group        

Visit http://www.survivorshipguidelines.org/ to find many of the Health Links translated into other languages.

Reference:

Children’s Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers, and related Health Links Version 4.0. October, 2013. www.survivorshipguidelines.org.

Source: Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta
Last Updated: 2/10/2015 7:20:16 PM
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