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Changes in body mass index during treatment of childhood acute lymphoblastic leukemia with the Nordic ALL2008
Christina Egnell1, Hanna Närhinen2, Andrea Merker1
1Astrid Lindgren Children's Hospital, Karolinska University Hospital, and the Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Insights
Young children (2-5 years) with acute lymphoblastic leukemia (ALL) who are at a healthy weight are most likely to become overweight during treatment. Identifying these children is key for targeted weight management interventions.
Area of Science:
- Pediatric Oncology
- Clinical Nutrition
- Public Health
Background:
- Children undergoing treatment for acute lymphoblastic leukemia (ALL) often experience significant weight gain.
- Overweight and obesity are associated with numerous adverse health outcomes, necessitating proactive interventions.
- Identifying pediatric ALL patients at higher risk for weight gain is crucial for developing targeted prophylactic strategies.
Purpose of the Study:
- To identify children with acute lymphoblastic leukemia (ALL) who are most susceptible to weight gain during cancer therapy.
- To analyze the prevalence and changes in body mass index (BMI) among pediatric ALL patients throughout their treatment course.
Main Methods:
- Utilized data from the NOPHO ALL2008 registry for patients aged 2.0-17.9 years at diagnosis.
- Collected height and weight data at the end of therapy via questionnaires.
- Calculated BMI standard deviation scores (SDS) to assess changes during treatment, using International Obesity Task Force cut-offs.
Main Results:
- Data from 765 children revealed a doubling in overweight and obesity rates during treatment (from 9.7% to 21.8% overweight, and 2.1% to 5.4% obese).
- The mean change in BMI SDS was +0.64.
- Younger children (2.0-5.9 years) and those with a healthy weight at diagnosis showed the highest propensity for becoming overweight (mean BMI SDS change of +0.85 and +0.65, respectively).
Conclusions:
- Younger children (2.0-5.9 years) with a healthy weight at the time of ALL diagnosis represent a key demographic at high risk for developing overweight during treatment.
- These findings highlight the importance of targeting interventions towards this specific subgroup of pediatric ALL patients to mitigate long-term health risks associated with obesity.
Objectives:
Children with acute lymphoblastic leukemia (ALL) have a tendency to gain weight during treatment. As overweight and obesity associate with health problems, prophylactic interventions are warranted. Therefore, it is important to identify the children most prone to gain weight.
Methods:
Patients aged 2.0-17.9 years at ALL diagnosis were identified from the NOPHO ALL2008 registry. Registry data was complemented with height and weight at the end of therapy from questionnaires. Body mass index (BMI) was classified according to international age- and sex-adjusted International Obesity Task Force BMI cut-offs. BMI values were transformed into standard deviation scores (SDS) to calculate the difference in BMISDS during treatment.
Results:
Data on BMI change were available for 765 children. Overweight and obesity doubled during treatment: 9.7% were overweight and 2.1% obese at diagnosis and 21.8% and 5.4% at the end of therapy, respectively. The mean BMISDS change was +0.64. Younger (2.0-5.9 years) and healthy weight children were most prone to become overweight (mean change in BMI SDS +0.85 and + 0.65, respectively).
Conclusions:
Younger children (2.0-5.9 years) with healthy weight at diagnosis were most prone to becoming overweight and therefore are an important group to target while considering interventions.
