Lipid and lipoprotein abnormalities in acute lymphoblastic leukemia survivors

Abstract

Acute lymphoblastic leukemia (ALL) accounts for 25% of all childhood malignancies and represents the most common form of leukemia in children. Cure rates for ALL now exceed 85%, allowing a growing number of childhood survivors to live into adulthood (1). However, survivors face severe, even life-threatening, long-term sequelae decades after the end of treatments (2, 3). Of interest, ALL survivors are at increased risk of developing cardiovascular conditions, including congestive heart failure, coronary artery disease, myocardial infarction, cardiac arrest, and cerebrovascular accidents (4-6). Studies on pediatric ALL survivors have reported a high prevalence of the typical components of the metabolic syndrome (MetS), such as obesity (7), hypertension (8), glucose tolerance (9), or dyslipidemia (10), and clustering of the three surrogates of MetS was also described (11). While chemo-and radiotherapy have often been associated with the development of these disorders in childhood cancer survivors (12-15), the precise etiology and the mechanisms of these late complications are not fully understood.