Patient case: 34-year-old female with melanoma; genetic feature: NRAS (Q61L)

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

Summary: 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.

Detailed description: We will enroll 60 female participants in this study. From the population of interest, female cancer survivors (or women treated for a related illness) who were treated with TBI prior to a SCT, we will enroll 30 participants, 10 from each of the following cancer groups: acute lymphoblastic leukemia, acute myeloid leukemia, and chronic myeloid leukemia. We are interested in determining the outcomes in adult survivors who have completed their growth by the time of study and yet are younger than the age when most women generally begin to develop insulin resistance or dyslipidemia in the general population. For this reason, we will enroll women who are 18 - 49 years of age at the time of study.

Eligibility: 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

Relevance to patient case: not relevant