Survivors of acute lymphoblastic leukemia and body mass changes

Obesity is a rapidly growing challenge that has now reached epidemic proportions. Along with malnutrition, it causes increasing morbidity and mortality in the general population. Survivors of pediatric leukemia are at increased risk of developing adverse body mass changes. Despite many studies, mechanisms of regulation of fat tissue metabolism are still poorly understood.

The present article reviews the data from studies of leukemia survivors in the context of basic science studies and reports of nutritional situation in Europe published between 1994 and 2009. As regulation of appetite and energy balance is very complex, environmental, biochemical and genetic factors are presented.

Fat mass and obesity associated gene (FTO) has recently been found to contribute to the risk of obesity. The possible role of this gene as well as late consequences of body mass changes are discussed.

Both underweight and overweight leukemia survivors need to be monitored for ongoing health consequences of abnormal BMI. Parameters of metabolic syndrome should be included as routine assessments in outpatient clinics taking care of childhood leukemia survivors.