Creatine monohydrate attenuates body fat accumulation in children with acute lymphoblastic leukemia during maintenance chemotherapy

BACKGROUND: Corticosteroids are an important component of the treatment of acute lymphoblastic leukemia (ALL), with known significantly negative effects on bone and muscle. Creatine monohydrate (CrM) supplementation may be an adjunctive therapeutic strategy to attenuate some of these adverse effects. PROCEDURE: Nine children with ALL in the maintenance phase of treatment on the Dana-Farber Cancer Institute (DFCI) protocol 2000-2001 were treated with CrM (0.1 g/kg/day) for two sequential periods of 16 weeks (16 weeks treat > 6 weeks wash-out > 16 weeks treat). A cohort of children (N = 50) who were receiving the same chemotherapy at the same time served as natural history controls. Measurements included height, weight, body mass index (BMI), and lumbar spine bone mineral density (LS-BMD), whole body bone mineral content (WB-BMC), fat-free mass (FFM), and percent body fat (%BF) using dual-energy X-ray absorptiometry. RESULTS: Despite the long course of corticosteroid treatment for ALL, children showed significant increases in height, LS-BMD, WB-BMC and FFM over approximately 38 weeks (P < 0.05) during the study. There was an increase in BMI over time, but children taking CrM had a reduction, while the natural history group showed an increase in % BF (P < 0.05 for interaction). CONCLUSIONS: Children with ALL treated with corticosteroids as part of a maintenance protocol of chemotherapy showed an increase in % BF that was attenuated by CrM supplementation.