Metabolic Syndrome in Childhood Cancer Survivors
Condition: Brain and Central Nervous System Tumors; Leukemia; Lymphoma; Metabolic Syndrome; Sarcoma
MeSH terms: Lymphoma; Leukemia; Sarcoma; Nervous System Neoplasms; Central Nervous System Neoplasms; Metabolic Syndrome; Syndrome
Study type: Observational

Summary: 
      RATIONALE: Gathering information about how often metabolic syndrome occurs in young survivors
      of childhood cancer may help doctors learn more about the disease.

      PURPOSE: This clinical trial is studying metabolic syndrome in survivors of childhood cancer
      and in their healthy sisters and brothers.
    

Detailed description: 
      OBJECTIVES:

      Primary

        -  Determine the manifestations of metabolic syndrome (MS) in children and adolescents who
           are survivors of childhood cancer (CCS).

        -  Compare the prevalence of MS in CCS to that of matched healthy siblings of similar age
           and gender.

        -  Evaluate insulin resistance (as measured by the euglycemic insulin clamp) in CCS and
           compare to that of healthy siblings of similar age and gender.

        -  Assess the extent to which prevalent obesity and insulin resistance are correlated with
           other factors that have been identified in the causal pathway associated with the
           development of the MS that may be altered in the CCS ( e.g., growth-hormone secretion,
           adipokines [adiponectin, leptin], inflammatory mediators [e.g., interleukin-6], tumor
           necrosis factor-α, and C-reactive protein).

        -  Obtain dietary and physical activity assessments of CCS and healthy siblings.

      Secondary

        -  Explore demographic (age at treatment, sex-specific differences) and treatment-related
           factors (exposures and dose-related associations with chemotherapeutic agents,
           radiation, steroids) as potential correlates with insulin resistance, vascular function,
           and MS in CCS.

      OUTLINE: Patients undergo a comprehensive medical examination including current and past
      medical history, family history, review of prescription medications, a physical examination
      including a body and visceral-fat assessment, and anthropometric (DEXA and bone-age x-ray)
      and blood pressure measurement. Blood samples are collected to measure growth hormone,
      adipokines (adiponectin, leptin), cytokines (IL-6 and CRP), fasting insulin, fasting glucose,
      lipids, oxidized LDL, hypothalami-pituitary-gonadal function (estrogen, FSH, LH,
      testosterone), and thyroid function (free T4 and TSH). Patients also complete questionnaires
      on dietary intake and physical activity.

      Healthy siblings undergo a complete medical examination as patients do, including blood
      samples collection and questionnaire administration.
    

Intervention name(s): metabolic assessment; questionnaire administration
Intervention type(s): Other; Other
Intervention description(s): Physical examination, medical history, blood pressure, anthropometrics, laboratory studies and other procedures (body composition, bone density, growth hormone, vascular, functional mobility, body fat assessments, etc).; Dietary habits will be evaluated using the Youth/ Adolescent Questionnaire (YAQ)and the Modifiable Activity Questionnaire for Adolescents (MAQA) will be used to assess participation in leisure time and competitive activities during the past year will be administered on Day 2.
Other intervention name(s): MAQA; AQA
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        The childhood cancer survivor (CCS) subjects for this study will be selected from Pediatric
        Oncology databases at the University of Minnesota Medical Center and Children"s Hospitals
        and Clinics of Minneapolis and St. Paul as described previously. CCS will complete a
        comprehensive evaluation in the Masonic Clinical Research Unit (MCRU) over a 2 day time
        period. The comparative data on normal children and adolescents will be obtained from
        healthy siblings frequency matched by age and gender and who will be evaluated in a manner
        similar to the CCS.
      
Biospecimen description: 
      A 22 gauge intravenous polyethylene catheter will be inserted into an antecubital vein of one
      arm and the necessary blood for all baseline laboratory studies will be obtained and
      processed as per standard protocol.
    
Keywords: metabolic syndrome; cancer survivor; childhood soft tissue sarcoma; unspecified childhood solid tumor, protocol specific; childhood acute lymphoblastic leukemia; childhood chronic myelogenous leukemia; childhood Hodgkin lymphoma; childhood non-Hodgkin lymphoma; childhood acute myeloid leukemia/other myeloid malignancies; chronic lymphocytic leukemia; childhood brain stem glioma; childhood cerebellar astrocytoma; childhood cerebral astrocytoma/malignant glioma; childhood choroid plexus tumor; childhood craniopharyngioma; childhood embryonal tumor; childhood ependymoma; childhood oligodendroglioma; childhood pineal parenchymal tumor; childhood mixed glioma; childhood subependymal giant cell astrocytoma; childhood visual pathway and hypothalamic glioma