Increased Body Mass Index during Therapy for Childhood Acute Lymphoblastic Leukemia: A Significant and Underestimated Complication
Objective & Design. We undertook a retrospective review of children diagnosed with acute lymphoblastic leukemia (ALL) and treated with modern COG protocols (n=80) to determine longitudinal changes in body mass index (BMI) and the prevalence of obesity compared with a healthy reference population...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | International Journal of Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2015/386413 |
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| author | Helen C. Atkinson Julie A. Marsh Shoshana R. Rath Rishi S. Kotecha Hazel Gough Mandy Taylor Thomas Walwyn Nicholas G. Gottardo Catherine H. Cole Catherine S. Choong |
| author_facet | Helen C. Atkinson Julie A. Marsh Shoshana R. Rath Rishi S. Kotecha Hazel Gough Mandy Taylor Thomas Walwyn Nicholas G. Gottardo Catherine H. Cole Catherine S. Choong |
| author_sort | Helen C. Atkinson |
| collection | DOAJ |
| description | Objective & Design. We undertook a retrospective review of children diagnosed with acute lymphoblastic leukemia (ALL) and treated with modern COG protocols (n=80) to determine longitudinal changes in body mass index (BMI) and the prevalence of obesity compared with a healthy reference population. Results. At diagnosis, the majority of patients (77.5%) were in the healthy weight category. During treatment, increases in BMI z-scores were greater for females than males; the prevalence of obesity increased from 10.3% to 44.8% (P<0.004) for females but remained relatively unchanged for males (9.8% to 13.7%, P=0.7). Longitudinal analysis using linear mixed-effects identified associations between BMI z-scores and time-dependent interactions with sex (P=0.0005), disease risk (P<0.0001), age (P=0.0001), and BMI z-score (P<0.0001) at diagnosis and total dose of steroid during maintenance (P=0.01). Predicted mean BMI z-scores at the end of therapy were greater for females with standard risk ALL irrespective of age at diagnosis and for males younger than 4 years of age at diagnosis with standard risk ALL. Conclusion. Females treated on standard risk protocols and younger males may be at greatest risk of becoming obese during treatment for ALL. These subgroups may benefit from intervention strategies to manage BMI during treatment for ALL. |
| format | Article |
| id | doaj-art-4e7137952094467681aab9f701bc3cef |
| institution | Kabale University |
| issn | 1687-9740 1687-9759 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Pediatrics |
| spelling | doaj-art-4e7137952094467681aab9f701bc3cef2025-02-03T01:31:12ZengWileyInternational Journal of Pediatrics1687-97401687-97592015-01-01201510.1155/2015/386413386413Increased Body Mass Index during Therapy for Childhood Acute Lymphoblastic Leukemia: A Significant and Underestimated ComplicationHelen C. Atkinson0Julie A. Marsh1Shoshana R. Rath2Rishi S. Kotecha3Hazel Gough4Mandy Taylor5Thomas Walwyn6Nicholas G. Gottardo7Catherine H. Cole8Catherine S. Choong9School of Paediatrics and Child Health, The University of Western Australia, Perth, WA 6009, AustraliaTelethon Kids Institute, The University of Western Australia, Perth, WA 6008, AustraliaSchool of Paediatrics and Child Health, The University of Western Australia, Perth, WA 6009, AustraliaSchool of Paediatrics and Child Health, The University of Western Australia, Perth, WA 6009, AustraliaDepartment of Oncology and Haematology, Princess Margaret Hospital, Perth, WA 6008, AustraliaDepartment of Radiation Oncology, Sir Charles Gairdner Hospital, Perth, WA 6009, AustraliaDepartment of Oncology and Haematology, Princess Margaret Hospital, Perth, WA 6008, AustraliaSchool of Paediatrics and Child Health, The University of Western Australia, Perth, WA 6009, AustraliaSchool of Paediatrics and Child Health, The University of Western Australia, Perth, WA 6009, AustraliaSchool of Paediatrics and Child Health, The University of Western Australia, Perth, WA 6009, AustraliaObjective & Design. We undertook a retrospective review of children diagnosed with acute lymphoblastic leukemia (ALL) and treated with modern COG protocols (n=80) to determine longitudinal changes in body mass index (BMI) and the prevalence of obesity compared with a healthy reference population. Results. At diagnosis, the majority of patients (77.5%) were in the healthy weight category. During treatment, increases in BMI z-scores were greater for females than males; the prevalence of obesity increased from 10.3% to 44.8% (P<0.004) for females but remained relatively unchanged for males (9.8% to 13.7%, P=0.7). Longitudinal analysis using linear mixed-effects identified associations between BMI z-scores and time-dependent interactions with sex (P=0.0005), disease risk (P<0.0001), age (P=0.0001), and BMI z-score (P<0.0001) at diagnosis and total dose of steroid during maintenance (P=0.01). Predicted mean BMI z-scores at the end of therapy were greater for females with standard risk ALL irrespective of age at diagnosis and for males younger than 4 years of age at diagnosis with standard risk ALL. Conclusion. Females treated on standard risk protocols and younger males may be at greatest risk of becoming obese during treatment for ALL. These subgroups may benefit from intervention strategies to manage BMI during treatment for ALL.http://dx.doi.org/10.1155/2015/386413 |
| spellingShingle | Helen C. Atkinson Julie A. Marsh Shoshana R. Rath Rishi S. Kotecha Hazel Gough Mandy Taylor Thomas Walwyn Nicholas G. Gottardo Catherine H. Cole Catherine S. Choong Increased Body Mass Index during Therapy for Childhood Acute Lymphoblastic Leukemia: A Significant and Underestimated Complication International Journal of Pediatrics |
| title | Increased Body Mass Index during Therapy for Childhood Acute Lymphoblastic Leukemia: A Significant and Underestimated Complication |
| title_full | Increased Body Mass Index during Therapy for Childhood Acute Lymphoblastic Leukemia: A Significant and Underestimated Complication |
| title_fullStr | Increased Body Mass Index during Therapy for Childhood Acute Lymphoblastic Leukemia: A Significant and Underestimated Complication |
| title_full_unstemmed | Increased Body Mass Index during Therapy for Childhood Acute Lymphoblastic Leukemia: A Significant and Underestimated Complication |
| title_short | Increased Body Mass Index during Therapy for Childhood Acute Lymphoblastic Leukemia: A Significant and Underestimated Complication |
| title_sort | increased body mass index during therapy for childhood acute lymphoblastic leukemia a significant and underestimated complication |
| url | http://dx.doi.org/10.1155/2015/386413 |
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