title: Weight change during childhood acute lymphoblastic leukemia induction therapy predicts obesity: a report from the Children's Oncology Group.
abstract: BACKGROUND
  Obesity is a well documented problem associated with childhood acute lymphoblastic leukemia (ALL) with increasing body mass index often observed during therapy. This study aims to evaluate if weight gain, early in therapy, is predictive of obesity at the end of treatment.
  
  
  METHODS
  In this secondary analysis, data from 1,017 high-risk ALL patients previously treated on a Children's Oncology Group protocol (CCG study 1961) were reviewed. Logistic regression was used to examine whether change in BMI z-score at Induction or Delayed Intensification (DI) 1 were predictive of obesity at the end of therapy.
  
  
  RESULTS
  The BMI z-score at the beginning of Induction and the change in BMI z-score during Induction were both significant predictors of obesity at the end of therapy. The change in BMI z-score during cycle 1 of DI was not found to be associated with obesity.
  
  
  CONCLUSIONS
  It is well know that obesity at the beginning of therapy is predictive of obesity at the end of ALL therapy. The new, and more important, finding from this study is that even after adjusting for baseline weight, the increase in BMI z-scores during induction was an independent predictor of obesity at the end of therapy. Most researchers agree that prevention is the best form of treatment for obesity as it is difficult to reverse once it is present. This study suggests that monitoring weight trends during Induction may be useful in guiding healthcare practitioners in identifying which patients are at highest risk for obesity development so that early intervention may occur.
authors.affiliation: Children's Cancer Center, Palmetto Health, Columbia, South Carolina.
authors.forename: Janice S
authors.initials: JS
authors.lastname: Withycombe
authors.forename: Lynette M
authors.initials: LM
authors.lastname: Smith
authors.forename: Jane L
authors.initials: JL
authors.lastname: Meza
authors.forename: Carrie
authors.initials: C
authors.lastname: Merkle
authors.forename: Melissa Spezia
authors.initials: MS
authors.lastname: Faulkner
authors.forename: Leslie
authors.initials: L
authors.lastname: Ritter
authors.forename: Nita L
authors.initials: NL
authors.lastname: Seibel
authors.forename: Ki
authors.initials: K
authors.lastname: Moore
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D060828:Induction Chemotherapy; D007223:Infant; D009765:Obesity / Q000139:chemically induced / Q000503:physiopathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000503:physiopathology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D015430:Weight Gain / Q000187:drug effects*
keywords: acute lymphoblastic leukemia; childhood; obesity; weight gain