TY - JOUR
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.
N1 - Publisher Copyright:
© 2015 Wiley Periodicals, Inc.
PY - 2015/6/1
Y1 - 2015/6/1
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.
KW - Acute lymphoblastic leukemia
KW - Body mass index
KW - Cancer survivors
KW - Children
KW - Obesity
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U2 - 10.1002/pbc.25411
DO - 10.1002/pbc.25411
M3 - Article
C2 - 25663378
AN - SCOPUS:84927796319
SN - 1545-5009
VL - 62
SP - 1035
EP - 1041
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
IS - 6
ER -