Document Detail

Body mass index and blood pressure changes over the course of treatment of pediatric acute lymphoblastic leukemia.
MedLine Citation:
PMID:  20860019     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Obesity and hypertension are reported among survivors of pediatric acute lymphoblastic leukemia (ALL). However, little is known about the trajectory of body mass index (BMI) and blood pressure over the course of ALL therapy.
PROCEDURE: In a retrospective cohort of 183 pediatric ALL patients diagnosed from 2000 to 2008, prevalence, severity, and risk factors for obesity and hypertension were assessed during treatment.
RESULTS: At diagnosis, 36% of patients were overweight and 19% were obese. Median BMI increased during induction therapy with a return to baseline soon after, but increased again over the first 22 months of maintenance therapy. At the end of therapy, 49% were overweight and 21% were obese. Increased BMI z-score at diagnosis was associated with increased z-score during maintenance (P < 0.001). Elevated parental BMI was associated with elevated BMI at diagnosis. Median BMI z-score increased over the first 22 months of maintenance (P < 0.001). Patients with high risk disease had lower BMI z-scores regardless of cranial radiotherapy exposure (P < 0.001). Pre-hypertension was prevalent over the course of therapy (31.1% with systolic pre-hypertension and 18.6% with diastolic pre-hypertension). Hypertension was also highly prevalent with 41.5% meeting systolic criteria and 24.0% meeting diastolic criteria.
CONCLUSIONS: During ALL therapy, patients are at risk for early development of elevated BMI and blood pressure, which places them at potentially increased risk for future adverse health conditions. Future studies are needed to develop strategies to mitigate these risks, such as potential reduction of corticosteroid pulses or a family-based diet and exercise intervention during maintenance therapy.
Adam J Esbenshade; Jill H Simmons; Tatsuki Koyama; Elizabeth Koehler; James A Whitlock; Debra L Friedman
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Pediatric blood & cancer     Volume:  56     ISSN:  1545-5017     ISO Abbreviation:  Pediatr Blood Cancer     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-01-12     Completed Date:  2011-03-01     Revised Date:  2013-07-23    
Medline Journal Info:
Nlm Unique ID:  101186624     Medline TA:  Pediatr Blood Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  372-8     Citation Subset:  IM    
Copyright Information:
© 2010 Wiley-Liss, Inc.
Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee 37232, USA.
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MeSH Terms
Blood Pressure*
Body Mass Index
Child, Preschool
Cohort Studies
Hypertension / etiology*
Obesity / etiology*
Overweight / etiology
Precursor Cell Lymphoblastic Leukemia-Lymphoma / physiopathology,  therapy*
Retrospective Studies
Risk Factors
Young Adult
Grant Support

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