Therapy-related changes in body size in Hispanic children with acute lymphoblastic leukemia

Authors

  • Jacques Baillargeon Ph.D.,

    Corresponding author
    1. Center for Epidemiology and Biostatistics, University of Texas Health Science Center, San Antonio, Texas
    2. Department of Pediatrics, University of Texas Health Science Center, San Antonio, Texas
    • Center for Epidemiology and Biostatistics, University of Texas Health Sciences Center at San Antonio, 7703 Floyd Curl Drive, MSC 7933, San Antonio TX 78229-3900
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    • Fax: (210) 562-9025

  • Anne-Marie Langevin M.D.,

    1. Department of Pediatrics, University of Texas Health Science Center, San Antonio, Texas
    2. Division of Pediatric Hematology/Oncology, CHRISTUS Santa Rosa Children's Hospital, San Antonio, Texas
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  • Margaret Lewis M.S.,

    1. Department of Pediatrics, University of Texas Health Science Center, San Antonio, Texas
    2. Division of Pediatric Hematology/Oncology, CHRISTUS Santa Rosa Children's Hospital, San Antonio, Texas
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  • James J. Grady M.P.H., Dr.P.H.,

    1. Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas
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  • Paul J. Thomas M.D.,

    1. Department of Pediatrics, University of Texas Health Science Center, San Antonio, Texas
    2. Division of Pediatric Hematology/Oncology, CHRISTUS Santa Rosa Children's Hospital, San Antonio, Texas
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  • Judith Mullins M.D.,

    1. Division of Pediatric Hematology/Oncology, Driscoll Children's Hospital, Corpus Christi, Texas
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  • Jaime Estrada M.D.,

    1. Division of Pediatric Hematology/Oncology, Methodist Children's Hospital of South Texas, San Antonio, Texas
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  • Aaron Pitney M.D.,

    1. Division of Pediatric Hematology/Oncology, Wilford Hall Medical Center, San Antonio, Texas
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  • Nancy Sacks M.S., R.D.,

    1. Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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  • Brad H. Pollock M.P.H., Ph.D.

    1. Center for Epidemiology and Biostatistics, University of Texas Health Science Center, San Antonio, Texas
    2. Department of Pediatrics, University of Texas Health Science Center, San Antonio, Texas
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  • The opinions or assertions contained herein are the private views of the authors and are not to be construed as reflecting the opinions of the Department of the Army or the Department of Defense.

Abstract

BACKGROUND

The objective of this study was to examine changes over time in body mass index (BMI) from diagnosis through chemotherapy for pediatric patients with B-precursor acute lymphoblastic leukemia (ALL).

METHODS

The study cohort consisted of 141 white Hispanic pediatric patients who were diagnosed with ALL and were treated at 2 South Texas pediatric oncology centers between 1993 and 2002. Changes in age-standardized and gender-standardized BMI scores were assessed.

RESULTS

The study cohort exhibited a steady increase in age-adjusted and gender-adjusted BMI scores for the first 12 months of therapy, a modest increase in BMI scores during the 18–23 month and 24–29 month periods, followed by a slight decrease in BMI scores at 30 months (end of therapy). A repeated-measures analysis indicated significant effects for time (P = 0.019) and time by baseline BMI category interaction (P = 0.0001) but no significant interaction effect between time and gender (P = 0.65).

CONCLUSIONS

Although it is known that leukemia therapy is associated with prevalent obesity in survivorship, its pattern of development during therapy has not been elucidated. In the current cohort of Hispanic children with ALL, BMI scores were elevated at diagnosis (mean ± standard deviation standardized BMI Z score, 0.33 ± 1.4), then increased, and remained elevated for the entire duration of chemotherapy. Patients who were classified as normal weight exhibited an increase in BMI over time; patients who were classified as overweight at diagnosis exhibited BMI patterns that were relatively stable; and patients who were classified as obese exhibited a very slight decline over time. These findings suggest that the risk for chemotherapy-related weight gain applies predominantly to children who begin ALL therapy within a normal weight range. Cancer 2005. © 2005 American Cancer Society.

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