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Patterns of obesity in boys and girls after treatment for acute lymphoblastic leukaemia
I Odame1, J J Reilly, B E Gibson
1Royal Hospital for Sick Children, Yorkhill, Glasgow.
Insights
Childhood acute lymphoblastic leukemia (ALL) survivors, especially girls, show increased obesity risk following cranial radiotherapy. This highlights a significant long-term health concern for these young patients.
Area of Science:
- Pediatric Oncology
- Endocrinology
- Radiotherapy Research
Background:
- Childhood acute lymphoblastic leukemia (ALL) is a common cancer in children.
- Survivors of ALL often face long-term health complications.
- Cranial radiotherapy is a standard treatment for ALL but may have adverse effects.
Purpose of the Study:
- To investigate the incidence and pattern of obesity in pediatric ALL survivors.
- To determine the impact of cranial radiotherapy on body mass index (BMI) in ALL survivors.
- To compare obesity trends in ALL survivors with a control group.
Main Methods:
- Retrospective analysis of height and weight data from 40 ALL survivors (boys and girls) at 0, 2, and 4 years post-diagnosis.
- Calculation of Body Mass Index (BMI) Z scores using standard tables.
- Comparison with a control group of 18 children who received chemotherapy but not radiotherapy.
Main Results:
- ALL survivors showed a significant increase in BMI Z scores by 2 years post-diagnosis, particularly girls.
- By 4 years, ALL boys had a slight BMI decrease, while ALL girls experienced further BMI increase (57% > 2 BMI Z scores).
- Control group BMI increased non-significantly over the same period.
Conclusions:
- Obesity is a pronounced long-term complication in childhood ALL survivors, more so in girls.
- Cranial radiotherapy is identified as a significant contributing factor to obesity development in these patients.
- This underscores the need for monitoring and management of obesity in ALL survivors.
Abstract:
The frequency and pattern of obesity in survivors of acute lymphoblastic leukaemia (ALL) was examined in a retrospective analysis of height and weight at zero, two, and four years from diagnosis in 40 children (19 boys and 21 girls). The children had been treated according to the Medical Research Council protocols UKALL VIII and X, both of which included cranial radiotherapy at a dose of 1800 cGy. Body mass index (BMI), determined as weight/height, was used as a measure of fatness. The BMI Z scores were calculated for each patient from standard tables. The ALL group was compared with a control group of 18 age matched children who had received chemotherapy but no radiotherapy. Changes in BMI between diagnosis and two and four years later were analysed by paired t tests. Mean BMI Z scores at diagnosis were similar between ALL boys, ALL girls, and the control group. Two years after diagnosis the ALL group, particularly the girls, showed a significant increase in BMI. By four years BMI had decreased slightly in the ALL boys, but had increased still further in the ALL girls with 57% having BMI Z scores greater than 2. In the control group BMI increased, but not significantly, at two and four years. It is concluded that the obesity seen in patients treated for ALL is more pronounced in girls than boys, and that cranial irradiation is an important factor.