We report five consecutive patients who underwent
hematopoietic stem cell transplantation (HSCT) to treat
leukemia or
neuroblastoma early in their lives and later manifested abnormal patterns of adipose tissue distribution. Lipoatrophy was remarkable in the gluteal regions and extremities, whereas subcutaneous fat was preserved in the cheeks, neck, and abdomen. In addition, visceral fat deposition, fatty changes in the liver, and metabolic derangements such as
insulin resistance and
hypertriglyceridemia were evident. These features resemble Dunnigan-type
familial partial lipodystrophy, which is a rare condition caused by LMNA gene mutation. These patients shared a common medical history involving HSCT, including conditioning with total body irradiation (TBI). They also received intensive
chemotherapy because of multiple
metastases (n = 3), relapse (n = 3), and repetitive HSCT (n = 3). We propose HSCT as a new etiology for
acquired partial lipodystrophy and recommend that patients who undergo HSCT with TBI and intensive
chemotherapy early in their lives must receive careful observation for the possible development of
lipodystrophy and metabolic complications.