Body composition in children in remission from acute lymphoblastic leukemia (original) (raw)
Related papers
Cancer, 2018
Children with acute lymphoblastic leukemia (ALL) have an increased risk of obesity and short stature. To the authors' knowledge, data regarding patients treated on contemporary protocols without cranial irradiation are limited. Changes in z scores for body mass index (BMI), height, and weight from the time of diagnosis to 5 years off therapy were evaluated using multivariable analysis in 372 children with ALL who were aged 2 to 18 years at the time of diagnosis and were enrolled on the St. Jude Children's Research Hospital Total XV protocol from 2000 through 2007. The percentage of overweight/obese patients increased from 25.5% at the time of diagnosis to approximately 50% during the off-therapy period. Median BMI z scores increased significantly during glucocorticoid therapy (induction: ∆0.56; 95% confidence interval [95% CI], 0.29-0.64 [P<.001]; and reinduction II: ∆0.22; 95% CI, 0.13-0.49 [P=.001]) and during the first year after therapy (∆0.18; 95% CI, 0.08-0.46 [P=.0...
International Journal of Pediatrics, 2015
Objective & Design. We undertook a retrospective review of children diagnosed with acute lymphoblastic leukemia (ALL) and treated with modern COG protocols ( = 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 -scores were greater for females than males; the prevalence of obesity increased from 10.3% to 44.8% ( < 0.004) for females but remained relatively unchanged for males (9.8% to 13.7%, = 0.7). Longitudinal analysis using linear mixed-effects identified associations between BMI -scores and time-dependent interactions with sex ( = 0.0005), disease risk ( < 0.0001), age ( = 0.0001), and BMI -score ( < 0.0001) at diagnosis and total dose of steroid during maintenance ( = 0.01). Predicted mean BMI -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.
Premature Adiposity Rebound in Children Treated for Acute Lymphoblastic Leukemia*
The Journal of Clinical Endocrinology & Metabolism, 2001
The adiposity rebound (AR), when body mass index begins to increase after its nadir in childhood, is a critical period for the regulation of energy balance and adult obesity risk. The aim of the present study was to test whether children treated for acute lymphoblastic leukemia (ALL) experience premature AR. This might, in part, explain their tendency to develop obesity. Timing of AR was assessed by visual inspection of body mass index plots in 68 patients treated for ALL in first remission. This sample comprised all eligible patients treated in Scotland between 1991 and 1998, age 30 months or less at the time of diagnosis. Timing of AR in patients was compared against a cohort of 889 healthy British children studied during the 1990s using the same method. AR occurred significantly earlier in the patients treated for ALL (2 test, P Ͻ 0.001). The AR had occurred in 43% (29 of 68) of the patients and 4% (40 of 889) of the comparison group by age 37 months. At 49 months AR had occurred in 81% (55 of 68) of the patients and 21% (190 of 889) of the comparison group. Treatment of ALL is associated with a significantly advanced AR. This might, in part, explain the extremely high prevalence of obesity in long-term survivors. Clinical management should focus on minimizing excess weight gain during therapy to reduce long-term obesity risk.
Body composition in young adult survivors of childhood acute lymphoblastic leukaemia
European Journal of Endocrinology, 2005
Objective: Obesity is frequently reported in patients treated for childhood leukaemia. Obesity, particularly abdominal obesity, is one of the main characteristics of the metabolic syndrome and a risk factor for cardiovascular disease and non-insulin-dependent diabetes mellitus (NIDDM). Design: All patients treated for acute lymphoblastic leukaemia (ALL) before the onset of puberty in the region of western Sweden, between 1973 and 1985, and in first remission, were included. 35 out of 47 patients aged 20-32 years participated. 19 patients had received cranial radiotherapy, and the median follow-up time was 20 years. The focus of this report was to study body composition and signs of the metabolic syndrome and correlate the findings to spontaneous growth hormone (GH) secretion. Methods: Body composition was assessed using dual-energy X-ray absorbtiometry (DEXA). We analyzed serum concentrations of insulin, glucose, leptin and lipids. Results: No patient was obese according to World Health Organization criteria (body mass index, BMI $ 30 kg/m 2 ) but one-third were overweight (BMI 25-29.9 kg/m 2 ). The maximal GH peak during 24 h (GH max ) was correlated to percentage of total body fat (r ¼ 2 0.42; P ¼ 0.017), trunk fat (r ¼ 2 0.5; P ¼ 0.005) and fat-free mass (r ¼ 0.42; P ¼ 0.017). GH max was also correlated to s-triglycerides (r ¼ 2 0.54; P ¼ 0.001), low-density lipoprotein-cholesterol (r ¼ 2 0.382; P ¼ 0.024) and high-density lipoprotein-cholesterol (r ¼ 0.45; P ¼ 0.007). Conclusions: We found little effect on BMI but an increased percentage of total body fat, especially trunk fat, and a tendency for an unfavourable lipid profile in adult survivors of childhood leukaemia. These findings were related to low endogenous GH secretion due to cranial irradiation.
A cross-sectional study of overweight in pediatric survivors of acute lymphoblastic leukemia (ALL)
Pediatric Blood & Cancer, 2011
Over the past 25 years, the prevalence of overweight in children and adolescents has doubled and obesity has tripled such that childhood overweight is now considered a public health crisis . This population of overweight children and adolescents is at increased risk for morbidity and mortality from chronic health diseases including diabetes, coronary artery disease, and other overweight-related illnesses during adulthood . Overweight has also been associated with an increased risk for the development of cancer during adulthood, and overweight adults with cancer have inferior survival outcomes .
Obesity in Survivors of Childhood Acute Lymphoblastic Leukemia and Lymphoma
Journal of Clinical Oncology, 2007
Purpose We evaluated the long-term effects of treatment on the body mass index (BMI) of children with acute lymphoblastic leukemia (ALL) or lymphoblastic lymphoma who received one of three CNS-directed therapies: intrathecal methotrexate with intravenous high-dose methotrexate (1 g/m2), intrathecal methotrexate with 18 Gy cranial radiation, or intrathecal methotrexate with 24 Gy cranial radiation. Patients and Methods Between 1979 and 1984, 456 children with newly diagnosed ALL and lymphoma were enrolled onto a single protocol at St Jude Children's Research Hospital (Memphis, TN). The heights and weights of 422 of the children were measured at diagnosis, during treatment, at the end of therapy, and approximately every 6 to 12 months thereafter. Patients who had attained their adult height at the time of analysis (n = 248) were placed in weight categories based on their BMI, BMI percentile, or weight-for-length percentile depending on age. Results The overall percentage of surviv...
Patterns of obesity in boys and girls after treatment for acute lymphoblastic leukaemia
Archives of Disease in Childhood, 1994
The frequency and pattern of obesity in survivors of acute lymphoblastic leukaemia (ALL) was examined in a retrospective analysis ofheight and weight at zero, two, and four years from diagnosis in 40 children (19 boys and 21 girls). The children had been treated according to the Medical Research Council protocols UKALL VIII and X, both ofwhich included cranial radiotherapy at a dose of 1800 cGy. Body mass index (BMI), determined as weight/height2, was used as a measure of fatness. The BMI Z scores were calculated for each patient from standard tables. The ALL group was compared with a control group of 18 age matched children who had received chemotherapy but no radiotherapy. Changes in BMI between diagnosis and two and four years later were
2016
1Student’s Scientific Society, Department of Pediatric Hematology, Oncology and Transplantation, Medical University in Lublin Head of Department: Professor Jerzy R. Kowalczyk, MD, PhD 2Faculty of Medicine, Medical University of Warsaw Head of Faculty: Professor Krzysztof J. Filipiak, MD, PhD 3Department of Clinical Genetics, Medical University in Lublin Head of Department: Janusz Kocki, MD, PhD 4Department of Pediatric Hematology, Oncology and Transplantation, Medical University in Lublin Head of Department: Professor Jerzy R. Kowalczyk, MD, PhD
Body composition and phase angle in Russian children in remission from acute lymphoblastic leukemia
Journal of Physics: Conference Series, 2010
Elevated degree of body fatness and changes in other body composition parameters are known to be common effects of treatment for acute lymphoblastic leukemia (ALL) in children. In order to study peculiarities of somatic growth and development in ALL survivors, we describe the results of BIA body composition analysis of 112 boys and 108 girls aged 5-18 years in remission from ALL (remission time range 1-13 years) compared to data from the same number of age-and sex-matched healthy controls (n=220). Detrimental effect on height in ALL boys was observed, whereas girls experienced additional weight gain compared to healthy subjects. In ALL patients, resistance, body fat, and percent body fat were significantly increased. The reactance, phase angle, absolute and relative values of skeletal muscle and body cell mass were significantly decreased. Principal component analysis revealed an early prevalence of adiposity traits in the somatic growth and development of ALL girls compared to healthy controls.
Weight status during and after childhood acute lymphoblastic leukaemia
2013
I must thank from my heart Allah, the Almighty, who enabled me to do this work. My praise and thanks go always to him. I would like to extend my sincere gratitude to my supervisor Professor John Reilly for all his help, encouragement, support and excellent supervision. He has given time, patience and guidance throughout my studies, and I would have been unable to complete this thesis without his efforts. Also, during the thesis I have become indebted to many people. I am grateful to all of King Faisal Specialised Hospital & Research Centre nurses, technicians, dieticians