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Early Increase in Weight Is Seen During Treatment for Paediatric Acute Lymphoblastic Leukaemia-A Retrospective
Håkon Endal1, Bjørn Helge Handegård2, Katrine Nordeng Mellem3
1Institute of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
Insights
Children with acute lymphoblastic leukaemia (ALL) experienced initial weight loss and height stagnation. However, weight and BMI increased significantly during and after treatment, highlighting the need for nutritional monitoring.
Area of Science:
- Pediatric Oncology
- Growth Monitoring
- Childhood Cancer Research
Background:
- Acute lymphoblastic leukemia (ALL) is a common childhood cancer.
- Growth patterns in children undergoing ALL treatment require careful assessment.
- Understanding long-term growth outcomes is crucial for pediatric cancer survivors.
Purpose of the Study:
- To evaluate growth trajectories in a national cohort of children diagnosed with ALL.
- To analyze anthropometric changes from diagnosis through 10 years post-treatment.
- To compare growth z-scores to a healthy Norwegian reference population.
Main Methods:
- Retrospective analysis of medical records from four Norwegian pediatric oncology centers.
- Inclusion of 375 children diagnosed with ALL between 2008 and 2018.
- Weekly anthropometric data collection and analysis using generalized additive mixed models.
Main Results:
- Initial weight loss (z-score 0.00 to -0.25) and height stagnation (z-score 0.20 to -0.55) observed.
- Weight and BMI stabilized significantly above average during and after treatment (z-scores 0.30 and 0.55).
- Height showed no significant difference from the general population in remission (z-score -0.15).
Conclusions:
- Weight gain and BMI increase in pediatric ALL patients occurred earlier than previously documented.
- Cancer treatment negatively impacted height growth.
- Continuous monitoring of nutritional status, support, and physical activity is vital to manage growth fluctuations.
Aim:
The aim of the study was to assess growth patterns in a national cohort of children aged 0-17.9 years diagnosed with acute lymphoblastic leukaemia (ALL).
Methods:
Medical records at the four tertiary paediatric oncology hospitals in Norway were used for retrospective data collection. Anthropometrics were collected for patients diagnosed between 1 January 2008 and 31 December 2018, weekly, or as soon after as available, and followed up for 10 years after diagnosis. Z-scores were collected from the growth curve function in the medical record software and compared to the Norwegian reference population. Generalised additive mixed model was used for analysis.
Results:
The analysis included 375 paediatric ALL patients. Data displayed an initial weight loss (z-score from 0.00 to -0.25) and a stagnation in height growth (z-score from 0.20 to -0.55). Throughout treatment and into remission, weight and body mass index stabilised significantly above the average healthy population (z-score: 0.30 and 0.55 respectively). Height was nonsignificantly different in remission compared to the general population (z-score: -0.15).
Conclusion:
Weight gain, and BMI increase, occurred earlier than previously reported. Height was negatively affected by treatment. Monitoring of nutritional status, nutritional support efforts and physical activity is important throughout treatment to prevent unwanted and avoidable fluctuations in growth.
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