title: Body composition after bone marrow transplantation in childhood.
abstract: OBJECTIVE
  To describe the body composition and fat distribution of childhood bone marrow transplantation (BMT) survivors at least one year post-transplantation and examine the ability of the Centers for Disease Control and Prevention criteria to identify survivors with elevated body fat percentage.
  
  
  METHODS
  Cross-sectional, descriptive.
  
  
  METHODS
  Pediatric oncology program at a National Cancer Institute-designated comprehensive cancer center.
  
  
  METHODS
  48 childhood BMT survivors (27 males and 21 females).
  
  
  METHODS
  Measurements included dual-energy x-ray absorptiometry scan, height, weight, and physical activity. Descriptive statistics were reported and mixed-model linear regression models were used to describe findings and associations.
  
  
  METHODS
  Total body fat percentage and central obesity (defined as a ratio of central to peripheral fat of 1 or greater).
  
  
  RESULTS
  Fifty-four percent of survivors had body fat percentages that exceeded recommendations for healthy body composition and 31% qualified as having central obesity. Previous treatment with total body irradiation was associated with higher body fat percentage and central obesity, and graft-versus-host disease was associated with lower body fat percentage. The body mass index (BMI) criteria did not correctly identify the BMT survivors who had elevated body fat percentage.
  
  
  CONCLUSIONS
  Survivors of childhood BMT are at risk for obesity and central obesity that is not readily identified with standard BMI criteria.
  
  
  CONCLUSIONS
  Nurses caring for BMT survivors should include evaluation of general and central obesity in their assessments. Patient education materials and resources for healthy weight and muscle building should be made available to survivors. Research is needed to develop appropriate interventions.
authors.affiliation: School of Medicine, Johns Hopkins University, Baltimore, MD, USA. rubleka@jhmi.edu
authors.forename: Kathy
authors.initials: K
authors.lastname: Ruble
authors.forename: Matthew
authors.initials: M
authors.lastname: Hayat
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Stewart
authors.forename: Allen
authors.initials: A
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D001823:Body Composition; D050218:Body Fat Distribution / Q000706:statistics & numerical data*; D015992:Body Mass Index; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000175:diagnosis / Q000209:etiology*; D012016:Reference Values; D012306:Risk; D017741:Survivors / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult