Effect of treatment on lipid profile, A-FABP levels, and nutritional status in pediatric patients with acute lymphoblastic leukemia and Hodgkin’s lymphoma

Background
Childhood hematological cancer survivors are more likely to develop dyslipidemia, obesity, and metabolic syndrome as adults.

Objectives
The study evaluated the impact of long-term steroid therapy on lipid profiles and A-FABP levels in patients with acute lymphoblastic leukemia (ALL) or Hodgkin’s lymphoma (HL) shortly after completing oncological treatment.

Material and methods
The study comprised 22 patients (median age, 10.33 years; males, 63.6%), including 14 patients with ALL and 8 patients with HL. Triglycerides, total cholesterol (TC), adipocyte fatty acid-binding protein (A-FABP), body mass index (BMI), upper arm muscle area (UAMA), and arm fat index (AFI) were assessed at diagnosis, at 3 months of cancer treatment, and after completion of treatment. Associations between these variables and selected demographic and clinical factors were assessed.

Results
Dyslipidemia was prevalent, with hypertriglyceridemia being the most common disorder. TC levels were highest after treatment completion and lowest at diagnosis (p < 0.001). Significant changes in BMI and UAMA were observed post-treatment (p < 0.05). Overweight or obesity was noted in 40.9% of patients at the end of treatment. Higher A-FABP levels were consistently associated with overnutrition (p < 0.05). Increased UAMA and AFI values were linked to elevated A-FABP levels (p < 0.001). Older age at diagnosis was associated with TC lipid abnormalities, and TC levels were a significant positive predictor of triglycerides levels.

Conclusions
Lipid disorders are frequent in patients with hematological malignancies undergoing long-term steroid therapy and may contribute to an increased risk of obesity and metabolic syndrome. Regular monitoring of lipid profiles and nutritional status is essential for early detection and management of these complications. Further studies are needed to evaluate the potential role of A-FABP as a predictive marker of metabolic disturbances.