Patterns of Obesity during Anti-cancer Chemotherapy in Children with Acute Lymphoblastic Leukemia

Mi-Seon Ko; Jung-Yun Kim; Yeon-Jung Lim; Young-Ho Lee; Hye-Sung An; Jae-Ho Yoo; Jeh-Hoon Shin

doi:10.5045/kjh.2008.43.2.77

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Ko, Kim, Lim, Lee, An, Yoo, and Shin: Patterns of Obesity during Anti-cancer Chemotherapy in Children with Acute Lymphoblastic Leukemia

Original Article

Korean J Hematol 2008;43(2):77-82.

Published online: 19 June 2008

DOI: https://doi.org/10.5045/kjh.2008.43.2.77

Patterns of Obesity during Anti-cancer Chemotherapy in Children with Acute Lymphoblastic Leukemia

Mi-Seon Ko¹, Jung-Yun Kim¹, Yeon-Jung Lim^1,, Young-Ho Lee¹, Hye-Sung An², Jae-Ho Yoo², Jeh-Hoon Shin¹

¹Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea

²Dong-A University College of Medicine, Busan, Korea

Correspondence to：Yeon-Jung Lim Department of Pediatrics, Hanyang University Hospital San 17, Haengdang-dong, Seongdong-gu, Seoul 133-791, Korea Tel: ＋82-2-2290-8358, Fax: ＋82-2-2297-2380 E-mail: heagori@hanmail.net

Received 15 April 2008 Revised 3 June 2008 Accepted 10 June 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background:

We evaluated the pattern as well as the predictive factors of obesity in children with acute lymphoblastic leukemia (ALL) according to body mass index (BMI) changes that occur during anticancer chemotherapy.

Methods:

We reviewed the medical records of 58 patients who were diagnosed with ALL between 1995 and 2006 at the Department of Pediatrics at Hanyang University Hospital and Dong-A University Hospital. Five relapsed cases were excluded. The heights and weights of 55 children were measured at diagnosis, after induction, after consolidation, before maintenance and at the end of therapy. We analyzed the body mass index (BMI, kg/m²) for each treatment phase and evaluated the BMI differences for patients who received or did not receive cranial radiotherapy.

Results:

The BMI increased in five children (10.4%) among the 48 children who were not obese at diagnosis. According to the treatment phase, the BMI of study patients significantly increased during induction and during chemotherapy. Even though the BMI also significantly increased according to the treatment phases in the children who underwent cranial radiotherapy, the BMI differences between patients that received or did not receive cranial radiotherapy were not statistically significant.

Conclusion:

We suggest that the risk for obesity in children with ALL should be considered even during chemotherapy. Physical activities, including physiotherapy, should be encouraged to prevent obesity, particularly during the long-term use of corticosteroids and during hospital admission.

Keywords: Body mass index (BMI), Children, Acute lymphoblastic leukemia (ALL)

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Fig. 1

BMI change during treatment.

Table 1.

Characteristics of subjects at diagnosis

	Mean±SD	Range
Age (yr)	7.0±3.6	1.8∼14.8
Height (cm)	121.6±25.8	77.0∼176.0
Weight (kg)	27.2±15.3	9.7∼70.0
BMI (kg/m²)	17.1±2.7	12.0∼24.3

Table 2.

BMI according to treatment phase

Treatment phase	BMI (Kg/m²)
At diagnosis	17.1±2.7
After induction	17.5±2.8
After consolidation	17.7±2.5
Pre-maintenance	18.4±2.8
Off-therapy	19.2±2.9

Table 3.

Patterns of BMI according to the presence of obesity at diagnosis

	At diagnosis	After induction	After consolidation	Pre-maintenance	Off-therapy	P-value
Obese	22.0±1.7	22.8±2.9	21.8±1.7	21.9±1.8	NA∗	＞0.05
Non-obese	16.3±1.9	16.8±2.1	17.2±2.1	17.9±2.5	19.2±3.0	0.002

Abbreviation: ∗NA, not available.

Table 4.

Patterns of BMI according to treatment phase with or without cranial irradiation

	At diagnosis	After induction	After consolidation	Pre-maintenance	Off-therapy
No RT (n=43)	16.9±2.9	17.3±3.1	17.6±2.8	18.1±2.8	18.3±2.8
RT∗ (n=12)	17.7±2.0	17.9±1.8	17.9±1.3	19.1±2.3	19.9±3.0
P-value	0.187	0.228	0.435	0.262	0.201

Abbreviation: ∗RT, radiotherapy (18Gy: 10, 24Gy: 1, 30Gy: 1).

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