Exercise and QUality diet After Leukemia: A randomized weight loss trial among adult survivors of childhood leukemia in the Childhood Cancer Survivor Study Journal Article
| Authors: | Friedman, D. N.; Chou, J. F.; Clark, J. M.; Moskowitz, C. S.; Ford, J. S.; Armstrong, G. T.; Mubdi, N. Z.; McDonald, A.; Nathan, P. C.; Sklar, C. A.; Ramanathan, L. V.; Robison, L. L.; Oeffinger, K. C.; Tonorezos, E. S. |
| Article Title: | Exercise and QUality diet After Leukemia: A randomized weight loss trial among adult survivors of childhood leukemia in the Childhood Cancer Survivor Study |
| Abstract: | Background: Obesity is prevalent in childhood cancer survivors and interacts with cancer treatments to potentiate risk for cardiovascular (CV) death. We tested a remote weight-loss intervention trial that was effective among adults with CV risk factors in a cohort of adult survivors of childhood acute lymphoblastic leukemia (ALL) with overweight/obesity. Methods: In this phase III efficacy trial, survivors of ALL enrolled in the Childhood Cancer Survivor Study with a body mass index ≥25 kg/m2 were randomized to a remotely delivered weight-loss intervention versus self-directed weight loss, stratified by history of cranial radiotherapy. The primary endpoint was the difference in weight loss at 24 months in an intent-to-treat analysis. Analyses were performed using linear mixed-effects models. Results: Among 358 survivors (59% female; median attained age: 37 years; IQR: 33–43 years), the baseline mean (SD) weight was 98.6 kg (24.0) for the intervention group (n 1⁄4 181) and 94.9 kg (20.3) for controls (n 1⁄4 177). Adherence to the intervention was poor; 15% of individuals in the intervention group completed 24/30 planned coaching calls. Weight at 24 months was available for 274 (77%) participants. After controlling for cranial radiotherapy,sex, race/ethnicity, and age, the mean (SE) change in weight from baseline to 24 months was 0.4 kg (0.8) for the intervention group and 0.2 kg (0.6) for control participants (P 1⁄4 0.59). Conclusions: A remote weight-loss intervention that was successful among adults with CV conditions did not result in significant weight loss among adult survivors of childhood ALL. Impact: Future interventions in this population must be tailored to the unique needs of survivors to encourage engagement and adherence. ©2024 American Association for Cancer Research. |
| Keywords: | adult; child; controlled study; major clinical study; clinical trial; cancer radiotherapy; outcome assessment; randomized controlled trial; radiotherapy; cohort analysis; weight loss; exercise; obesity; age; cancer survivor; diet; body mass; precursor cell lymphoblastic leukemia-lymphoma; phase 3 clinical trial; primary medical care; ethnicity; race; cancer survivors; cardiovascular risk factor; childhood cancer survivor; body weight loss; intention to treat analysis; humans; human; male; female; article; childhood acute lymphoblastic leukemia; b cell acute lymphoblastic leukemia |
| Journal Title: | Cancer Epidemiology Biomarkers and Prevention |
| Volume: | 33 |
| Issue: | 9 |
| ISSN: | 1055-9965 |
| Publisher: | American Association for Cancer Research |
| Date Published: | 2024-09-01 |
| Start Page: | 1158 |
| End Page: | 1166 |
| Language: | English |
| DOI: | 10.1158/1055-9965.Epi-23-1601 |
| PUBMED: | 38652494 |
| PROVIDER: | scopus |
| PMCID: | PMC11371536 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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