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

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.

Sex

Female

Minimum age

18 Years

Maximum age

49 Years

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

• BACKGROUNDOeffinger KC, Adams-Huet B, Victor RG, Church TS, Snell PG, Dunn AL, Eshelman-Kent DA, Ross R, Janiszewski PM, Turoff AJ, Brooks S, Vega GL. Insulin resistance and risk factors for cardiovascular disease in young adult survivors of childhood acute lymphoblastic leukemia. J Clin Oncol. 2009 Aug 1;27(22):3698-704. doi: 10.1200/JCO.2008.19.7251. Epub 2009 Jun 29. PMID 19564534