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Prevalence and predictors of weight loss during induction therapy for childhood acute lymphoblastic leukemia
Rachel Hill1, Tyler Hamby2, Danielle Johnson1
1Department of Pediatric Hematology/Oncology, Cook Children's Health Care System, Fort Worth, Texas.
Insights
A study found that 17% of children with acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma lost significant weight during induction therapy. High-risk disease, trisomy 21, and obesity were linked to this weight loss.
Area of Science:
- Pediatric Oncology
- Hematology
Background:
- Children undergoing induction therapy for acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma often gain weight.
- A subset of these patients experience weight loss, a concerning trend impacting treatment outcomes.
- Understanding predictors of weight loss in pediatric ALL is crucial for improved patient management.
Purpose of the Study:
- To determine the prevalence of weight loss during induction therapy in pediatric patients with ALL or lymphoblastic lymphoma.
- To identify clinical and biological predictors associated with weight loss in this patient cohort.
Main Methods:
- A retrospective analysis was conducted on 187 patients aged 2-20 years diagnosed with ALL or lymphoblastic lymphoma.
- Weight changes during induction therapy were analyzed to identify trends and significant weight loss (≥5%).
- Predictors for weight loss were statistically evaluated.
Main Results:
- Significant weight loss (≥5%) was observed in 17% of the studied pediatric patients.
- Factors positively associated with weight loss included high-risk disease, trisomy 21, and overweight/obesity at diagnosis.
- Hyperglycemia was also identified as a predictor for weight loss and inversely associated with weight gain.
Conclusions:
- Weight loss is an underrecognized issue in a significant minority of children with ALL during induction therapy.
- Identifying patients at risk for weight loss (e.g., those with high-risk disease, trisomy 21, obesity, or hyperglycemia) is important.
- Further research is needed to elucidate the causes and clinical significance of weight loss in pediatric ALL patients.
Objective:
Children with acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma often experience significant weight gain during induction therapy. However, a subgroup of patients may experience weight loss, which can impact outcomes; thus, identifying and understanding this underrecognized concern is important. Our aim was to identify the prevalence and predictors for weight loss during ALL induction therapy.
Methods:
This was a single-institution retrospective study of 187 patients, ages 2 to 20 y, diagnosed with ALL or lymphoblastic lymphoma. We analyzed weight trends during induction therapy and predictors of weight loss.
Results:
Significant weight loss (≥5%) occurred in 17% of patients. Having high-risk disease, trisomy 21, overweight/obese status at the time of diagnosis, and/or hyperglycemia were positively associated with weight loss and negatively associated with weight gain during induction therapy.
Conclusion:
Future studies should aim to better understand the etiology and importance of weight loss during induction therapy.
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