Obesity in adult survivors of childhood acute lymphoblastic leukemia: A report from the Childhood Cancer Survivor Study Journal Article


Authors: Oeffinger, K. C.; Mertens, A. C.; Sklar, C. A.; Yasui, Y.; Fears, T.; Stovall, M.; Vik, T. A.; Inskip, P. D.; Robison, L. L.
Article Title: Obesity in adult survivors of childhood acute lymphoblastic leukemia: A report from the Childhood Cancer Survivor Study
Abstract: Purpose: To determine whether adult survivors (≥ 18 years of age) of childhood acute lymphoblastic leukemia (ALL) are at increased risk for obesity and to assess patient and treatment variables that influence risk. Patients and Methods: A retrospective cohort of participants of the Childhood Cancer Survivor Study was used to compare 1,765 adult survivors of childhood ALL to 2,565 adult siblings of childhood cancer survivors. Body-mass index (BMI; kilograms per square meter), calculated from self-reported heights and weights, was used to determine the prevalence of being overweight (BMI, 25-29.9) or obese (BMI ≥ 30.0). Polytomous logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for being overweight or obese among ALL survivors relative to the sibling control group. Results: The age- and race-adjusted OR for being obese in survivors treated with cranial radiation doses ≥ 20 Gy in comparison with siblings was 2.59 for females (95% CI, 1.88 to 3.55; P < .001) and 1.86 for males (95% CI, 1.33 to 2.57; P < .001). The OR for obesity was greatest among females diagnosed at 0 to 4 years of age and treated with radiation doses ≥ 20 Gy (OR, 3.81; 95% CI, 2.34 to 5.99; P < .001). Obesity was not associated with treatment consisting of chemotherapy only or with cranial radiation doses of 10 to 19 Gy. Conclusion: Cranial radiotherapy ≥ 20 Gy is associated with an increased prevalence of obesity, especially in females treated at a young age. It is imperative that Healthcare professionals recognize this risk and develop strategies to enhance weight control and encourage longitudinal follow-up. © 2003 by American Society of Clinical Oncology.
Keywords: adolescent; adult; cancer chemotherapy; child; controlled study; preschool child; child, preschool; retrospective studies; major clinical study; cancer radiotherapy; radiation dose; radiotherapy; prevalence; odds ratio; obesity; patient assessment; retrospective study; acute lymphoblastic leukemia; childhood cancer; survivor; cancer survivor; risk assessment; risk; survivors; body mass; body mass index; infant; infant, newborn; newborn; acute lymphocytic leukemia; regression analysis; leukemia, lymphocytic, acute; humans; human; male; female; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 21
Issue: 7
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2003-04-01
Start Page: 1359
End Page: 1365
Language: English
DOI: 10.1200/jco.2003.06.131
PUBMED: 12663727
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 12 September 2014 -- Source: Scopus
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  1. Charles A Sklar
    312 Sklar