Increased Body Mass Index during Therapy for Childhood Acute Lymphoblastic Leukemia: A Significant and Underestimated Complication
Table 1
Selected characteristics of the ALL study cohort ().
Age at diagnosis years
Median (min–max)
Females ()
4.55 (1.49–16.59)
Males ()
6.31 (1.02–16.66)
Risk treatment category
N (%)
Standard risk
53 (66%)
High risk
27 (34%)
Diagnosis
N (%)
Pre-B ALL
71 (88.8%)
T cell ALL
9 (11.3%)
Treatment duration years†
Median (min–max)
Females
2.18 (0.73–2.36)
Males
3.18 (0.75–3.35)
BMI z-scores
Mean ± SD (median)
Start of treatment
Females
0.391 ± 1.080 (0.522)#
Males
0.163 ± 1.101 (0.186)#
End of treatment
Females
1.317 ± 0.983 (1.612)
Males
0.450 ± 1.117 (0.581)
Obesity prevalence#
N (%)
Start of treatment
Females
3/29 (10.3%)
Males
5/51 (9.8%)
End of treatment
Females
13/29 (44.8%)
Males
7/51 (13.7%)
Obesity incidence during treatmen
N (%)
Females
10/26 (38.5%)
Males
5/46 (10.9%)
Total dose of steroids (mg/m2)
Mean ± SD (median)
Premaintenance phases
Females
2680 ± 687 (2887)
Males
2827 ± 473 (2893)
Maintenance phases
Females
3933 ± 1293 (4087)
Males
5240 ± 2460 (6420)
Cranial radiotherapy
N (%)
None
68 (85%)
12 Gy
10 (12.5%)
18 Gy
2 (2.5%)
2 females and 6 males who did not complete maintenance treatment due to relapse (), moving overseas (), or electing to cease treatment (). #2 females and 4 males diagnosed before two years of age. BMI -scores calculated based on CDC 2000 growth curves for age ≥ 2 years and WHO 2006 growth curves for age < 2 years. Number of patients who became obese by the end of treatment who were not obese at diagnosis.
