title: A meta-analysis of body mass index of adolescent and adult survivors of pediatric acute lymphoblastic leukemia.
abstract: OBJECTIVE
  We conducted a meta-analysis of existing studies to examine body mass index (BMI) of adolescent and adult survivors of pediatric acute lymphoblastic leukemia (ALL) compared to individuals without cancer.
  
  
  METHODS
  Studies were identified and reviewed using specific inclusion criteria. The effect size was odds ratio (OR) of the prevalence of overweight/obese BMI (≥ 25 kg/m(2)) in ALL survivors versus comparison groups. Study data were coded and validated. Fixed-effects (FE) and random-effects (RE) estimates of the effect size were estimated.
  
  
  RESULTS
  A total of 9 studies met our inclusion criteria. Survivors were more likely to be overweight/obese compared to comparison groups (FE OR = 1.12, 95% CI 1.06-1.18 and RE OR = 1.28, 95% CI 1.07-1.53). When limited to studies from North American samples, female survivors were overweight/obese more often than the comparison groups (FE OR = 1.30, 95% CI 1.19-1.43).
  
  
  CONCLUSIONS
  Adolescent and adult survivors of pediatric ALL, especially female survivors, may be at a higher risk of being overweight/obese compared to individuals without cancer. However, few studies provided detailed information on patient and treatment factors (e.g., cranial radiation) that can impact BMI. Standardized reporting of study content is vital for providing robust information on the risk of developing late effects among cancer survivors.
  
  
  CONCLUSIONS
  Adolescent and adult survivors of pediatric ALL require additional weight management resources such as targeted counseling for physical activity and dietician support both early in treatment and after the end of their therapy. Female survivors may need additional guidance to develop healthy eating practices and to participate in exercise programs.
authors.affiliation: Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA.
authors.forename: Gina E
authors.initials: GE
authors.lastname: Nam
authors.forename: Sapna
authors.initials: S
authors.lastname: Kaul
authors.forename: Yelena P
authors.initials: YP
authors.lastname: Wu
authors.forename: Richard E
authors.initials: RE
authors.lastname: Nelson
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wright
authors.forename: Mark N
authors.initials: MN
authors.lastname: Fluchel
authors.forename: Claire C
authors.initials: CC
authors.lastname: Hacking
authors.forename: Anne C
authors.initials: AC
authors.lastname: Kirchhoff
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000628:therapy; D017741:Survivors; D055815:Young Adult