title: Therapy-related changes in body size in Hispanic children with acute lymphoblastic leukemia.
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.
authors.affiliation: Center for Epidemiology and Biostatistics, University of Texas Health Science Center, San Antonio, Texas 78229-3900, USA. baillargeon@uthscsa.edu
authors.forename: Jacques
authors.initials: J
authors.lastname: Baillargeon
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Langevin
authors.forename: Margaret
authors.initials: M
authors.lastname: Lewis
authors.forename: James J
authors.initials: JJ
authors.lastname: Grady
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Thomas
authors.forename: Judith
authors.initials: J
authors.lastname: Mullins
authors.forename: Jaime
authors.initials: J
authors.lastname: Estrada
authors.forename: Aaron
authors.initials: A
authors.lastname: Pitney
authors.forename: Nancy
authors.initials: N
authors.lastname: Sacks
authors.forename: Brad H
authors.initials: BH
authors.lastname: Pollock
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects / Q000528:radiation effects; D002648:Child; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D009765:Obesity / Q000209:etiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000208:ethnology / Q000628:therapy*; D012307:Risk Factors; D017741:Survivors