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Demographic correlates of body size changes in children undergoing treatment for acute lymphoblastic leukemia
Author(s) -
Baillargeon Jacques,
Langevin AnneMarie,
Lewis Margaret,
Estrada Jaime,
Grady James J.,
Mullins Judith,
Pitney Aaron,
Pollock Brad H.
Publication year - 2007
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21063
Subject(s) - medicine , cohort , body mass index , survivorship curve , chemotherapy , pediatrics , obesity , lymphoblastic leukemia , cohort study , pediatric cancer , leukemia , cancer
Abstract Introduction While it is known that leukemia therapy is associated with obesity in survivorship, limited information is available on its time‐related pattern of development and its variation across patient subgroups. The goal of the present study was to examine demographic correlates of body mass index (BMI) changes over time from diagnosis through chemotherapy for children with B‐precursor acute lymphoblastic leukemia (ALL). Methods The study cohort consisted of 307 pediatric patients diagnosed with ALL who were treated at four South Texas pediatric oncology centers between 1990 and 2002. To minimize treatment‐related variability, we excluded patients who received cranial irradiation as part of their treatment. Variation in age‐ and gender‐standardized BMI z‐scores according to age at diagnosis, gender, and ethnicity were assessed. Results The overall study cohort exhibited an increase in age‐ and gender‐adjusted BMI z‐scores for the first 24 months of chemotherapy followed by a slight decrease in BMI at 30 months (end of therapy). A repeated measures analysis indicated a statistically significant difference in the time‐related pattern of BMI changes for age at diagnosis ( P = 0.001) but no significant effect for gender ( P = 0.32) or Hispanic versus non‐Hispanic ethnicity ( P = 0.89). Discussion In our cohort of ALL patients, BMI was elevated at diagnosis (mean standardized BMI z‐score = 0.22, standard deviation = 1.4) then increased and remained elevated for the entire duration of chemotherapy. Children who were 2–9 years of age at diagnosis began therapy with a substantially lower BMI and remained lower over the course of chemotherapy than patients aged 10–18 years at diagnosis. It will be important for future investigations to explore the biological and behavioral factors that may underlie such differential patterns of BMI change over time. Pediatr Blood Cancer 2007;49:793–796. © 2006 Wiley‐Liss, Inc.