Survivors of standard risk acute lymphoblastic leukemia do not have increased risk for overweight and obesity compared to non-cancer peers: A report from the Children's Oncology Group

Susan J. Lindemulder, Linda C. Stork, Bruce Bostrom, Xiaomin Lu, Meenakshi Devidas, Stephen Hunger, Joseph P. Neglia, Nina S. Kadan-Lottick

Research output: Contribution to journalArticle

24 Scopus citations


Background: We sought to determine whether survivors of standard risk ALL (SR-ALL) treated without cranial radiation have increased risk for obesity by assessing changes in body mass index (BMI) during and after treatment; identifying contributing patient and treatment factors; comparing rates of overweight/obese to national health data. Procedure: Eligibility for this retrospective cohort study included: (i) previous enrollment on legacy therapy trials CCG1922 or CCG1952; (ii) continuous first remission; and (iii) age at follow-up evaluation of 6-16.99 years. Height and weight from diagnosis, consolidation, start of maintenance, last cycle of maintenance, and off-therapy were analyzed. Results: The 269 subjects were a median age of 3.5 years at diagnosis and 13.3 years at follow-up. BMI% significantly increased from induction to consolidation (+17.6±1.6%), start of maintenance to end-of-treatment (+3.3±1.6%) and decreased from end-of-treatment to follow-up (-3.5±1.6%,). Higher BMI% at follow-up was associated with higher BMI% at diagnosis (P<0.0001), but not age at diagnosis, gender, or race. Patients previously randomized to dexamethasone had a stronger association between BMI% at diagnosis and BMI% at follow-up than those who received prednisone (P=0.0005). At follow-up, 39% of survivors were overweight or obese; the relative risk of overweight/obese was 1.028 (P=0.738) compared to the general population. Conclusions: Our study of patients with SR-ALL found a significant increase in BMI% largely during the first month of therapy that is greater with dexamethasone than prednisone. However, after therapy, there was no increased risk of overweight/obese BMI compared to non-cancer peers.

Original languageEnglish (US)
Pages (from-to)1035-1041
Number of pages7
JournalPediatric Blood and Cancer
Issue number6
StatePublished - Jun 1 2015



  • Acute lymphoblastic leukemia
  • Body mass index
  • Cancer survivors
  • Children
  • Obesity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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