Survivors of standard risk acute lymphoblastic leukemia do not have increased risk for overweight and obesity compared to non-cancer peers: A report from the Children's Oncology Group

Susan J. Lindemulder, Linda C. Stork, Bruce Bostrom, Xiaomin Lu, Meenakshi Devidas, Stephen Hunger, Joseph P Neglia, Nina S. Kadan-Lottick

Research output: Contribution to journalArticle

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Abstract

Background: We sought to determine whether survivors of standard risk ALL (SR-ALL) treated without cranial radiation have increased risk for obesity by assessing changes in body mass index (BMI) during and after treatment; identifying contributing patient and treatment factors; comparing rates of overweight/obese to national health data. Procedure: Eligibility for this retrospective cohort study included: (i) previous enrollment on legacy therapy trials CCG1922 or CCG1952; (ii) continuous first remission; and (iii) age at follow-up evaluation of 6-16.99 years. Height and weight from diagnosis, consolidation, start of maintenance, last cycle of maintenance, and off-therapy were analyzed. Results: The 269 subjects were a median age of 3.5 years at diagnosis and 13.3 years at follow-up. BMI% significantly increased from induction to consolidation (+17.6±1.6%), start of maintenance to end-of-treatment (+3.3±1.6%) and decreased from end-of-treatment to follow-up (-3.5±1.6%,). Higher BMI% at follow-up was associated with higher BMI% at diagnosis (P<0.0001), but not age at diagnosis, gender, or race. Patients previously randomized to dexamethasone had a stronger association between BMI% at diagnosis and BMI% at follow-up than those who received prednisone (P=0.0005). At follow-up, 39% of survivors were overweight or obese; the relative risk of overweight/obese was 1.028 (P=0.738) compared to the general population. Conclusions: Our study of patients with SR-ALL found a significant increase in BMI% largely during the first month of therapy that is greater with dexamethasone than prednisone. However, after therapy, there was no increased risk of overweight/obese BMI compared to non-cancer peers.

Original languageEnglish (US)
Pages (from-to)1035-1041
Number of pages7
JournalPediatric Blood and Cancer
Volume62
Issue number6
DOIs
StatePublished - Jun 1 2015

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Precursor Cell Lymphoblastic Leukemia-Lymphoma
Survivors
Body Mass Index
Obesity
Maintenance
Therapeutics
Prednisone
Dexamethasone
Cohort Studies
Retrospective Studies
Radiation
Weights and Measures
Health
Population

Keywords

  • Acute lymphoblastic leukemia
  • Body mass index
  • Cancer survivors
  • Children
  • Obesity

Cite this

Survivors of standard risk acute lymphoblastic leukemia do not have increased risk for overweight and obesity compared to non-cancer peers : A report from the Children's Oncology Group. / Lindemulder, Susan J.; Stork, Linda C.; Bostrom, Bruce; Lu, Xiaomin; Devidas, Meenakshi; Hunger, Stephen; Neglia, Joseph P; Kadan-Lottick, Nina S.

In: Pediatric Blood and Cancer, Vol. 62, No. 6, 01.06.2015, p. 1035-1041.

Research output: Contribution to journalArticle

Lindemulder, Susan J. ; Stork, Linda C. ; Bostrom, Bruce ; Lu, Xiaomin ; Devidas, Meenakshi ; Hunger, Stephen ; Neglia, Joseph P ; Kadan-Lottick, Nina S. / Survivors of standard risk acute lymphoblastic leukemia do not have increased risk for overweight and obesity compared to non-cancer peers : A report from the Children's Oncology Group. In: Pediatric Blood and Cancer. 2015 ; Vol. 62, No. 6. pp. 1035-1041.
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T1 - Survivors of standard risk acute lymphoblastic leukemia do not have increased risk for overweight and obesity compared to non-cancer peers

T2 - A report from the Children's Oncology Group

AU - Lindemulder, Susan J.

AU - Stork, Linda C.

AU - Bostrom, Bruce

AU - Lu, Xiaomin

AU - Devidas, Meenakshi

AU - Hunger, Stephen

AU - Neglia, Joseph P

AU - Kadan-Lottick, Nina S.

PY - 2015/6/1

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N2 - Background: We sought to determine whether survivors of standard risk ALL (SR-ALL) treated without cranial radiation have increased risk for obesity by assessing changes in body mass index (BMI) during and after treatment; identifying contributing patient and treatment factors; comparing rates of overweight/obese to national health data. Procedure: Eligibility for this retrospective cohort study included: (i) previous enrollment on legacy therapy trials CCG1922 or CCG1952; (ii) continuous first remission; and (iii) age at follow-up evaluation of 6-16.99 years. Height and weight from diagnosis, consolidation, start of maintenance, last cycle of maintenance, and off-therapy were analyzed. Results: The 269 subjects were a median age of 3.5 years at diagnosis and 13.3 years at follow-up. BMI% significantly increased from induction to consolidation (+17.6±1.6%), start of maintenance to end-of-treatment (+3.3±1.6%) and decreased from end-of-treatment to follow-up (-3.5±1.6%,). Higher BMI% at follow-up was associated with higher BMI% at diagnosis (P<0.0001), but not age at diagnosis, gender, or race. Patients previously randomized to dexamethasone had a stronger association between BMI% at diagnosis and BMI% at follow-up than those who received prednisone (P=0.0005). At follow-up, 39% of survivors were overweight or obese; the relative risk of overweight/obese was 1.028 (P=0.738) compared to the general population. Conclusions: Our study of patients with SR-ALL found a significant increase in BMI% largely during the first month of therapy that is greater with dexamethasone than prednisone. However, after therapy, there was no increased risk of overweight/obese BMI compared to non-cancer peers.

AB - Background: We sought to determine whether survivors of standard risk ALL (SR-ALL) treated without cranial radiation have increased risk for obesity by assessing changes in body mass index (BMI) during and after treatment; identifying contributing patient and treatment factors; comparing rates of overweight/obese to national health data. Procedure: Eligibility for this retrospective cohort study included: (i) previous enrollment on legacy therapy trials CCG1922 or CCG1952; (ii) continuous first remission; and (iii) age at follow-up evaluation of 6-16.99 years. Height and weight from diagnosis, consolidation, start of maintenance, last cycle of maintenance, and off-therapy were analyzed. Results: The 269 subjects were a median age of 3.5 years at diagnosis and 13.3 years at follow-up. BMI% significantly increased from induction to consolidation (+17.6±1.6%), start of maintenance to end-of-treatment (+3.3±1.6%) and decreased from end-of-treatment to follow-up (-3.5±1.6%,). Higher BMI% at follow-up was associated with higher BMI% at diagnosis (P<0.0001), but not age at diagnosis, gender, or race. Patients previously randomized to dexamethasone had a stronger association between BMI% at diagnosis and BMI% at follow-up than those who received prednisone (P=0.0005). At follow-up, 39% of survivors were overweight or obese; the relative risk of overweight/obese was 1.028 (P=0.738) compared to the general population. Conclusions: Our study of patients with SR-ALL found a significant increase in BMI% largely during the first month of therapy that is greater with dexamethasone than prednisone. However, after therapy, there was no increased risk of overweight/obese BMI compared to non-cancer peers.

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