Body mass index and annual increase of body mass index in long-term childhood cancer survivors; relationship to treatment.
OBJECTIVE
Evaluation of body mass index (BMI) at final height (FH) and annual BMI increase in adult childhood cancer survivors (CCS) after treatment with anthracyclines, platinum, and/or radiotherapy.


METHODS
BMI (weight/height²) was calculated retrospectively from diagnosis until FH. The prevalence of underweight (BMI < 18.5 kg/m(2)) and overweight (BMI ≥ 25 kg/m(2))/obesity (BMI ≥ 30 kg/m(2)) at FH was compared with age-matched controls. The association between underweight/overweight at FH and treatment was assessed by multivariate logistic regression. Annual BMI increase after treatment was assessed by multilevel analysis. Analyses were adjusted for age and underweight/overweight at diagnosis, and age at FH.


RESULTS
At FH the prevalence of overweight had not increased, while CCS experienced more underweight as compared to controls (14% vs. 4%, P < 0.001). Overweight at FH was associated with cranial/craniospinal radiotherapy (CRT; OR, 2.23; 95% CI, 1.17-4.26) and underweight at FH with anthracyclines > 300 mg/m(2) (OR, 2.84; 95% CI, 1.33-6.06). Annual BMI increase was +0.47 (0.34-0.60) kg/m(2)/year. In CCS, the annual BMI increase was greater in those with CRT ≥ 30 Gy as compared with those with less or no CRT (+0.15 kg/m(2)/year [0.04-0.25 kg/m(2)/year], P = 0.008) and smaller in those with a higher cumulative anthracycline dose (-0.03 kg/m(2)/year [-0.05 to -0.0005 kg/m(2)/year] per 100 mg/m(2), P = 0.046).


CONCLUSIONS
After treatment with anthracyclines, platinum, and/or radiotherapy, CRT-treated survivors have more overweight at FH, and a greater annual BMI increase, while anthracycline-treated survivors have more underweight at FH and a lower annual BMI increase.
Beatrix Children's Hospital, Division of Paediatric Oncology, University Medical Centre Groningen and University of Groningen, PO Box 30.001, 9700 RB Groningen, the Netherlands.
Cornelia A J
CA
Brouwer
Jourik A
JA
Gietema
Judith M
JM
Vonk
W J E
WJ
Tissing
Hendrika M
HM
Boezen
Nynke
N
Zwart
Aleida
A
Postma
D000293:Adolescent; D000328:Adult; D018943:Anthracyclines / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009369:Neoplasms / Q000473:pathology* / Q000628:therapy; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology*; D017671:Platinum Compounds / Q000627:therapeutic use; D012189:Retrospective Studies; D017741:Survivors; D013851:Thinness / Q000453:epidemiology*; D055815:Young Adult
D018943:Anthracyclines; D000970:Antineoplastic Agents; D017671:Platinum Compounds
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