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Abstract
Therapeutic advances in the treatment of acute lymphoblastic leukemia (ALL) have increased the number of survivors but have promoted the development of long-term side effects, the best documented of which is obesity. The present retrospective case series analyzed data collected at diagnosis, end of treatment, and last follow-up visit of 210 ALL survivors treated between August 2005 and October 2014. Clinical and anthropometric data were collected from medical records. The nutritional diagnosis was based on z-scores of height-for-age (H/AZ) and body mass index-for-age (BMI/AZ) for males and females provided by the World Health Organization. H/AZ decreased and BMI/AZ increased between baseline and end of treatment, followed by H/AZ catch-up at follow-up. The prevalence of excess weight on the three occasions was 24.3%, 38.3, and 43.3%, respectively. Baseline excess weight (adjusted OR: 12.2; 95% CI: 5.5–27.0) and the ALL risk group (adjusted OR: 2.89; 95% CI: 1.1–7.6) were independently associated with excess weight at the end of treatment, whereas baseline excess weight (adjusted OR: 8.50; 95% CI: 3.93–18.40) and linear growth (adjusted OR: 2.02; 95% CI: 1.05–3.88) were independently associated with excess weight at follow-up. The frequency of excess weight had increased significantly by the end of treatment and persisted at follow-up. Baseline excess weight was the main factor associated with excess weight at the end of treatment and follow-up.
Acknowledgments
This article was developed with technical support from the Pediatric Oncology Unit of the Professor Fernando Figueira Institute of Integrative Medicine and own financing.
Conflict of Interest
The authors have no conflicts of interest to disclose.
This Article Was Developed
Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Pernambuco, Recife, Brazil.
Funding
The author(s) reported there is no funding associated with the work featured in this article.