Seki Yuko, Okamoto Yasuhiro, Kodama Yuichi, Nishikawa Takuro, Tanabe Takayuki, Nakagawa Shunsuke, Mizota Michiyo, Kawano Yoshifumi
Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
J Pediatr Hematol Oncol. 2018 Aug;40(6):e334-e337. doi: 10.1097/MPH.0000000000001098.
Weight gain is often observed in children with acute lymphoblastic leukemia (ALL) who undergo chemotherapy including steroids. An increase in body mass index (BMI)-standard deviation score (SDS) during induction therapy is reported as a risk factor for obesity after treatment. However, risk factors of an increase in BMI-SDS during induction therapy are not known. Ninety-six patients with ALL who were treated at our hospital between 1996 January and September 2013 were analyzed retrospectively. Daily body weight measurement was initiated in July 2005 in an attempt to control weight. Fifty-four patients were boys and 42 were girls. The median age at onset was 5.1 years (0.5-16.6 y), and 7.3% of patients were overweight/obese at onset. BMI-SDS increased +0.1% (-3.3% to +3.2%) during induction therapy. BMI-SDS increased by 1 and 2 or more SDs in 20% and 3% of patients, respectively. In multivariate analysis, non-high-risk treatment and earlier treatment start date (before daily body weight measurement) were independent risk factors. Ten percent of patients were overweight/obese at 3 years after completion therapy, and high BMI-SDS after induction therapy was a risk factor. Daily body weight measurement might prevent excess weight gain during induction therapy, resulting in patients maintaining a healthy weight after ALL treatment.
在接受包括类固醇在内的化疗的急性淋巴细胞白血病（ALL）患儿中，体重增加现象较为常见。据报道，诱导治疗期间体重指数（BMI）标准差评分（SDS）升高是治疗后肥胖的一个危险因素。然而，诱导治疗期间BMI-SDS升高的危险因素尚不清楚。我们对1996年1月至2013年9月在我院接受治疗的96例ALL患者进行了回顾性分析。2005年7月开始每日测量体重，以控制体重。54例为男孩，42例为女孩。发病时的中位年龄为5.1岁（0.5 - 16.6岁），7.3%的患者在发病时超重/肥胖。诱导治疗期间BMI-SDS升高了+0.1%（-3.3%至+3.2%）。分别有20%和3%的患者BMI-SDS升高了1个标准差和2个及以上标准差。多因素分析显示，非高危治疗和更早的治疗开始日期（在每日测量体重之前）是独立的危险因素。10%的患者在完成治疗3年后超重/肥胖，诱导治疗后高BMI-SDS是一个危险因素。每日测量体重可能会预防诱导治疗期间体重过度增加，从而使ALL患者在治疗后保持健康体重。
