Longitudinal changes in obesity and body mass index among adult survivors of childhood acute lymphoblastic leukemia: A report from the childhood cancer survivor study Journal Article


Authors: Garmey, E. G.; Liu, Q.; Sklar, C. A.; Meacham, L. R.; Mertens, A. C.; Stovall, M. A.; Yasui, Y.; Robison, L. L.; Oeffinger, K. C.
Article Title: Longitudinal changes in obesity and body mass index among adult survivors of childhood acute lymphoblastic leukemia: A report from the childhood cancer survivor study
Abstract: Purpose: We examined the rate of increase in the body mass index (BMI; kg/m2) after final height attainment in survivors of acute lymphoblastic leukemia (ALL) and a noncancer comparison group. Methods: Childhood Cancer Survivor Study (CCSS) is a retrospectively ascertained cohort study that prospectively tracks the health status of adults who were diagnosed with childhood cancer between 1970 and 1986 and a comparison group of siblings. Changes in BMI from baseline enrollment to time of completion of follow-up (mean interval, 7.8 years) were calculated for 1,451 ALL survivors (mean age, 32.3 years at follow-up) and 2,167 siblings of childhood cancer survivors (mean age, 35.9 years). Results: The mean BMI of the CCSS sibling comparison group increased with age (women, 0.25 units/yr, 95% CI, 0.22 to 0.28 units; men, 0.23 units/yr, 95% CI, 0.20 to 0.25 units). Compared with CCSS siblings, ALL survivors who were treated with cranial radiation therapy (CRT) had a significantly greater increase in BMI (women, 0.41 units/yr, 95% CI, 0.37 to 0.45 units; men, 0.29 units/yr; 95% CI, 0.26 to 0.32 units). The rate of BMI increase was not significantly increased for ALL survivors who were treated with chemotherapy alone. Younger age at CRT exposure significantly modified risk. Conclusion: CRT used in the treatment of childhood ALL is associated with a greater rate of increasing BMI, particularly among women treated with CRT during the first decade of life. Health care professionals should be aware of this risk and interventions to reduce or manage weight gain are essential in this high-risk population. © 2008 by American Society of Clinical Oncology.
Keywords: adolescent; adult; child; controlled study; retrospective studies; major clinical study; cancer patient; cancer radiotherapy; follow up; linear models; obesity; acute lymphoblastic leukemia; childhood cancer; cancer survivor; questionnaires; survivors; body mass; body mass index; health status; longitudinal studies; health care personnel; precursor cell lymphoblastic leukemia-lymphoma; body height; high risk population
Journal Title: Journal of Clinical Oncology
Volume: 26
Issue: 28
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2008-10-01
Start Page: 4639
End Page: 4645
Language: English
DOI: 10.1200/jco.2008.16.3527
PUBMED: 18824710
PROVIDER: scopus
PMCID: PMC2653124
DOI/URL:
Notes: --- - "Cited By (since 1996): 32" - "Export Date: 17 November 2011" - "CODEN: JCOND" - "Source: Scopus"
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  1. Charles A Sklar
    322 Sklar
  2. Kevin Oeffinger
    296 Oeffinger