Trajectories of obesity and overweight rates among survivors of childhood acute lymphoblastic leukemia

Purpose/Objectives: To describe the trajectories of obesity/overweight rates by age group among survivors of childhood acute lymphoblastic leukemia (ALL) from diagnosis through several years post-therapy. Design: Longitudinal, descriptive. Setting: Hematology/oncology clinic in the southwestern United States. Sample: 62 child and adolescent ALL survivors receiving treatment and follow-up care from 1999-2013. Methods: Retrospective chart review of height, weight, and body mass index. Main Research Variables: Annual obesity/overweight rates and developmental age groups. Findings: Different trajectories of obesity/overweight rates existed among age groups. Forty-seven percent of adolescents met the Centers for Disease Control and Prevention criteria for obesity/overweight status at some point following diagnosis, compared to 68% of school-age and 73% of preschool children. Preschool children demonstrated the most rapid rate increase following diagnosis, with a particularly susceptible period in the years immediately following therapy. Obesity/overweight persistence was most characteristic of school-age children. Conclusions: Important variations in rate and pattern of weight status trajectories exist by age group, demonstrating that children diagnosed with ALL during the preschool and school-age developmental years have the greatest vulnerability of developing obesity/overweight status. Implications for Nursing: Obesity/overweight prevention efforts are greatly needed in children with ALL, and efforts should occur before ALL treatment completion in preschool and school-age children.