Research suggests that pediatric acute lymphoblastic leukemia (ALL) survivors are at an increased risk of overweight and obesity compared to their unaffected contemporaries; however, this observation is based primarily from studies among non‐Hispanic whites. This study aims to describe the prevalence and correlates of overweight status among an ethnically diverse population of childhood ALL survivors.
METHODS: The study population included pediatric ALL patients diagnosed between 1972 and 2008 that were treated and followed by Texas Children's Cancer Center. Patient demographic and clinical data were abstracted from medical records. Individuals with a Body Mass Index (BMI) >25 kg/m2 (Ý19 years of age) or >85 percentile for age and sex (2‐19 years of age) were classified as overweight. The prevalence of overweight among childhood ALL survivors was compared to the U.S. general population prevalence estimated from NHANES 2011‐2012 data. Logistic regression models were constructed to describe the relationship between patient characteristics, treatment variables, and overweight status.
RESULTS: Post‐therapy BMI was available for 365 Hispanic (n=158) and non‐Hispanic white (n=208) patients with a mean follow‐up of 11.4 years post‐diagnosis. The prevalence of overweight was 59.2%, 44.1%, and 50.9% among survivors currently aged 6‐11, 12‐19, and >19 years, respectively. Compared to the general U.S. population, the prevalence of overweight was 73% higher among survivors ages 6‐11, 28% higher among survivors ages 12‐19, and 16% lower among survivors over 19 years of age. Hispanic ethnicity (Odds Ratio [OR]=2.15; 95% Confidence Interval [CI]:1.41‐3.27), being overweight (OR=6.65; 95% CI:2.86‐ 17.19) at the time of diagnosis, and receipt of cranial radiotherapy (OR=2.03; 95% CI:1.11‐3.74) were all associated with overweight status post‐therapy.
CONCLUSIONS: The prevalence of overweight is higher among younger (<19 years of age) survivors of childhood ALL than the general population. Certain patient and clinical characteristics, including ethnicity, patient BMI at diagnosis, and cranial radiotherapy, may predict post‐ therapy overweight status. This information may help identify childhood ALL patients that are at increased risk of being overweight following treatment.
