Weight status during and after childhood acute lymphoblastic leukaemia (original) (raw)
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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
Body composition in children in remission from acute lymphoblastic leukemia
Background: Changes in body composition are commonly reported in pediatric survivors of acute lymphoblastic leukemia (ALL). However , the effect of ALL and of its treatment on body composition in children in remission from ALL has not been fully examined with the use of a reference method. Objectives: We aimed to determine the body composition and composition of fat-free mass (FFM) in children in remission from ALL. We also aimed to compare the effects that prednisolone and dexa-methasone had on the body composition of an ALL survivor population. Design: This cross-sectional study measured height, weight, body volume, total body water, and bone mineral content in 24 children in remission from ALL and 24 age-matched, healthy control subjects. Body composition and FFM composition were evaluated by using the 4-component model. Results: The mean body mass index and fat mass index were significantly (P 0.05 for both) higher in the ALL survivors than in age-matched control subjects. The composition of the FFM in the 2 treatment groups was not observed to differ significantly. Examination of the composition of FFM made it evident that children in remission from ALL had both significantly greater hydration (P 0.001) and lower density (P 0.0001) of FFM than did the control children. Conclusions: Children in remission from ALL may develop excess body fat. To measure body composition accurately in an ALL population , the high hydration and low density of FFM in this population should be taken into consideration.
Nutritional Assessment of Children with Acute Lymphoblastic Leukemia
Background: The high prevalence of malnutrition in adult and pediatric cancer patients has been appreciated for decades and continues to be documented. Although the prognostic significance of nutritional status among patients with cancer remains controversial, it is generally accepted that the nutritional support is an important aspect of medical therapy. Objective: Assess the nutritional status of children with acute lymphoblastic leukemia at time of diagnosis of disease, assess the nutritional status of the same children during induction of chemotherapy and after induction by 3-6 weeks. Patients and methods: A prospective study was carried out on thirty children their age ranged from (1-14 year) with newly diagnosed acute lymphoblastic leukemia, (16) of them were males and (14) were females, who were admitted to the oncology pediatric Unit in Basrah Maternity and children Hospital, from the first of January to the end of October-2010). This study has been done to determine the nutritional status of children with newly diagnosed acute lymphoblastic leukemia before, during and after induction by (3-6 weeks). Full history was taken from each patient regarding chief compliant, dietary history, also clinical examination and anthropometric measurement by measure weight, height, mid upper arm circumference and body mass index, in addition investigation in form of Hb, serum albumin, serum cholesterol, and random blood sugar. Results: This study has revealed that among 30 patients with newly diagnosed ALL, 15 (50%) of them are underweight according to weight for age, 8 of them are male and 7 are females. Twelve (40%) of these 30 patients are wasted, 7 of them are male and 5 are female. Fourteen (46.7%) of the total 30 patients are malnourished according to body mass index, 6 of them are male and 8 are female, ten (33.3%) are malnourished according to mid upper arm circumference, five of them are male and 5 are female. The study has revealed that there is a statistically significant increase in mean body weight during induction with P value (0.046) and a statistically increase in body mass index during induction with P value (0.005). During induction, there is decrease in serum calcium with P value (0.001), and a significant decrease in serum albumin with P value (0.005), also in this study there is a significant decrease in serum cholesterol during induction with P value (0.001). There is no significant increase in random blood sugar during induction. Conclusion: Malnutrition exists in a significant proportion of children with acute lymphoblastic leukemia. So, adequate nutrition is an important in such children, to ensure optimal treatment and outcome.
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.
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...
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
Changes in nutritional status in adolescents surviving leukemia and lymphoma
Revista de Nutrição
Objective To examine the changes in the nutritional status of adolescents aged 10-19 years after a minimum 12 months interval following oncological treatment for leukemias and lymphomas. Methods Longitudinal design quantitative study conducted at Hospital de Clínicas, Porto Alegre. Adolescents aged 10-19 years after a minimum 12 months interval following oncological treatment for leukemias and lymphomas were included. The measures of weight, height, brachial circumference, triceps skinfold thickness, arm muscle circumference and abdominal circumference were collected. Results The sample comprised 50 adolescents who had survived leukemias and lymphomas. In the follow up 38% of the patients were classified as overweight according to the body mass index for their age. There was a significant increase in body mass index for age between the beginning and the end of treatment and follow up (p=0.013) in female individuals, compared to males. The results indicate a reduction in the Z-score ...
Haematology Journal of Bangladesh, 2021
Background: Adequate nutrition is an important concern in children with leukemia. Malnutrition and weight lost are common and are due to verity of mechanism involving the tumor, the host response to the tumor such as infection and pharmacokinetics of chemotherapeutic drugs. Objective: To evaluate and compare the nutritional status of children with ALL at diagnosis and after completion of induction therapy. Methodology: This prospective observational study included 60 children newly diagnosed as ALL, aged 2-15 years, over a period from April 2012 to September 2012 in the Department of Pediatric Hematology and Oncology, BSMMU. The anthropometric measurements and serum albumin level were taken. Anthropometric indices are calculated by NCHS (WHO-2000) and classified as Z score. Children
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.