Division of Gastroenterology, Department of Pediatrics, University of California, San Diego, California; Rady Children's Hospital, San Diego, California.
Pediatr Blood Cancer. 2014 May;61(5):894-900. doi: 10.1002/pbc.24937. Epub 2014 Jan 16.
Children surviving acute lymphoblastic leukemia (ALL) are at increased risk for overweight and obesity over that of the general population. Whether a generic or tailored approach to weight management is needed for cancer survivors has yet to be tested.
Thirty-eight youth 8-18 years with BMI ≥ 85% who had survived ALL were recruited for a randomized clinical trial evaluating a weight management intervention (WMI) tailored for childhood ALL survivors (Fit4Life). Fit4Life recipients received a 4-month web, phone, and text message-delivered WMI tailored for cancer survivorship. Controls received a general WMI delivered via phone and mail. Assessments were performed at baseline and 4 months. Outcome data were analyzed according to assigned treatment condition over time.
Most (80%, (70%, 100%) [median (IQR)]) of the assigned curriculum was received by Fit4Life participants as compared to 50% (40%, 65%) among controls. Fit4Life recipients ≥ 14 years demonstrated less weight gain (P = 0.05) and increased moderate-to-vigorous physical activity (P < 0.01) while all Fit4Life recipients reported reduced negative mood (P < 0.05) over time as compared to control counterparts.
We demonstrated acceptable feasibility of a WMI tailored for overweight and obese children surviving ALL utilizing a multimodal technology approach. Improved weight, weight-related behavior, and psychological outcomes were demonstrated among Fit4Life intervention as compared to youth receiving a generic WMI. Data from this pilot trial may be used to design a larger trial to determine whether youth of all ages also can derive a benefit from a cancer survivor-tailored WMI and whether short-term outcomes translate into improved long-term outcomes for childhood ALL survivors.
患有急性淋巴细胞白血病 (ALL) 的儿童超重和肥胖的风险高于普通人群。癌症幸存者是否需要采用通用或量身定制的方法来进行体重管理,这一点尚未得到验证。
招募了 38 名 8-18 岁、BMI≥85%的 ALL 幸存者参加一项随机临床试验,评估了针对儿童 ALL 幸存者量身定制的体重管理干预措施 (Fit4Life)。Fit4Life 组接受了为期 4 个月的基于网络、电话和短信的癌症幸存者特定的体重管理干预措施。对照组则接受了常规的电话和邮件提供的体重管理干预措施。在基线和 4 个月时进行评估。根据分配的治疗条件随时间分析结果数据。
与对照组的 50%(40%,65%)相比,大多数 Fit4Life 参与者(80%(70%,100%))接受了指定课程的大部分内容。与对照组相比,≥14 岁的 Fit4Life 参与者体重增加较少(P=0.05),中等至剧烈体力活动增加(P<0.01),而所有 Fit4Life 参与者报告负面情绪减少(P<0.05)。
我们证明了一种针对超重和肥胖 ALL 幸存者的体重管理干预措施的可行性,该干预措施是根据多模态技术量身定制的。与接受常规体重管理干预的对照组相比,Fit4Life 干预组的体重、与体重相关的行为和心理结果得到了改善。这项试点试验的数据可用于设计一项更大的试验,以确定是否所有年龄段的青少年都能从癌症幸存者特定的体重管理干预中受益,以及短期结果是否能转化为儿童 ALL 幸存者的长期结果改善。