Background

Survival following hematopoietic stem cell transplantation (HSCT) for a hematological malignancy in childhood has improved substantially through advances in transplantation procedures and supportive care. As a result, the number of long-term survivors continues to grow. While these improved outcomes represent a major success, survivors of HSCT remain at increased risk of developing adverse health consequences later in life. These late effects include metabolic syndrome, vascular dysfunction, as well as other aging-related morbidities that may be linked to accelerated aging. Although previous studies have highlighted these risks, important questions remain regarding the prevalence, co-occurrence, and underlying mechanisms in survivors of HSCT in childhood. In particular, the contribution of potentially modifiable factors, such as lifestyle behaviors and chronic low-grade inflammation, is not yet fully understood. The MetVasA-study aims to address these gaps in knowledge and ultimately contribute to improved long-term health and survivorship care. 

Aims

The primary aim of this study is to determine the prevalence of metabolic syndrome, endothelial dysfunction and accelerated aging, and to identify potential determinants of these outcomes, including treatment-related factors, lifestyle behaviors and chronic low-grade inflammation.

The secondary aims are to evaluate the prevalence of unhealthy lifestyle behaviors, to investigate the co-occurrence of MetS, ED and accelerated aging co-occur, to identify factors associated with this co-occurrence.

Project outcomes

• Asbroek LJ, van der Pal HJ, Fiocco M, Feijen EA, Grundeken LH, Koopman MM, van Litsenburg RR, van der Torre P, Westerink J, Kremer LC, Pluijm SM, Bresters D. Prevalence of and Risk Factors for Metabolic Syndrome, Vascular Damage, and Accelerated Aging (MetVasA) After Pediatric Hematopoietic Stem Cell Transplantation for Hematological Malignancy: Protocol for a Cross-Sectional Cohort Study. JMIR Res Protoc. 2026 Jun 16;15:e77429. doi: 10.2196/77429. 

Team

• dr. L. Asbroek, PhD candidate at Princess Máxima Center for Pediatric Oncology

• dr. D. Bresters, Princess Máxima Center for Pediatric Oncology

• Prof. dr. L.C.M. Kremer, Princess Máxima Center for Pediatric Oncology

• Prof.dr. M. Fiocco, Mathematical Institute Leiden University, Department of Biomedical Data Sciences Leiden University Medical Center & Princess Máxima Center for Pediatric Oncology 

• dr. S.M.F. Pluijm, Princess Máxima Center for Pediatric Oncology