Demographic correlates of body size changes in children undergoing treatment for acute lymphoblastic leukemia

Abstract

In our cohort of ALL patients, BMI was elevated at diagnosis (mean standardized BMI z-score = 0.22, standard deviation = 1.4) then increased and remained elevated for the entire duration of chemotherapy. Children who were 2-9 years of age at diagnosis began therapy with a substantially lower BMI and remained lower over the course of chemotherapy than patients aged 10-18 years at diagnosis. It will be important for future investigations to explore the biological and behavioral factors that may underlie such differential patterns of BMI change over time.

Obesity in Pediatric ALL Survivors: A Meta-Analysis

“…First, we performed the analysis after excluding 7 studies 29,33,34,[36][37][38][39] for which the mean BMI z score or its SD was not explicitly reported or could not be calculated based on subgroup values (for mean BMI z score) or 95% CIs (for SD of BMI z score). We also repeated the analysis after excluding 7 longitudinal studies that did not report sample size of survivors at the follow-up evaluation, 8,12,29,33,34,36,38,42 for which we substituted it with the sample size reported at cancer diagnosis assuming loss to follow-up was random. In addition, we performed a "leave-one-out meta-analysis" to evaluate the impact of individual studies on the summary estimates.…”

“…These survivors had completed treatment within 10 years at the time of study evaluation. 8,12,13,16,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] Only 2 studies 14,40 examined BMI z score assessed $10 years after the completion of treatment (ie, off treatment $10 years). Because neither study reported SD/SE of the BMI z score, the meta-analysis did not include survivors who were off treatment beyond 10 years.…”

“…10,11,14,34,47,51,60 However, the other 15 studies did not find evidence of a gender difference. [6][7][8]12,15,28,31,33,36,38,47,[52][53][54]62 FIGURE 2…”

“…[9][10][11] With the decreasing use of CRT by cooperative groups, it remains unclear whether intrathecal and systemic chemotherapy alone are associated with obesity in pediatric ALL survivors. Female gender and a young age at diagnosis were predictors for obesity in some [10][11][12][13][14] but not all studies. 7,9,12,15,16 The rate of obesity may also vary by interval from cancer diagnosis.…”

“…Female gender and a young age at diagnosis were predictors for obesity in some [10][11][12][13][14] but not all studies. 7,9,12,15,16 The rate of obesity may also vary by interval from cancer diagnosis. A better understanding of treatment and patient characteristics associated with obesity is needed to guide best clinical care and to inform targeted intervention.…”