Paediatric Haematology-Oncology Unit, Department of Paediatrics, Christian Medical College, Vellore, India.
Nutr Cancer. 2023;75(2):678-684. doi: 10.1080/01635581.2022.2152194. Epub 2022 Nov 29.
Survivors of childhood acute lymphoblastic leukemia (ALL) are vulnerable to late adverse events such as obesity and an associated metabolic syndrome.
Children treated for ALL from 2002 to 2012 were included. BMI was calculated at diagnosis, end of treatment, and 5, 8, and 10-years from diagnosis. BMI-centiles were used to categorize the patients: underweight (<5th-percentile), normal (5th-85th percentile), overweight (85th-95th percentile), and obese (≥95th centile).
The study included 179 children with ALL (median age: 59-months). The proportions of patients who were underweight, normal, overweight/obese, were 37%, 56% and 7%, respectively, at diagnosis; and 15%, 51% and 34%, respectively, at 5-years from diagnosis. The median (IQR) BMI Z-score at diagnosis was -1.12(-2.40, -0.26). The median (IQR) BMI z-score of the cohort was higher after 5 [0.22(-0.83,1.24), < 0.001] and 10-years of diagnosis [0.30(-0.69,0.99), < 0.001], respectively. The proportion of overweight/obese individuals was higher after 5 (34%, < 0.001) and 10 (26%, = 0.001) years. There was a significant correlation between the baseline BMI Z-score and that observed after 5-years (ρ = 0.49, < 0.001), and 10-years (ρ = 0.55, < 0.001).
At 10-years of follow-up, >25% of children with ALL were overweight/obese. The BMI Z-score at the time of diagnosis continued to correlate with the Z-score after 10-years.
儿童急性淋巴细胞白血病（ALL）幸存者易发生肥胖及相关代谢综合征等晚期不良事件。
纳入 2002 年至 2012 年接受 ALL 治疗的患儿。在诊断时、治疗结束时及诊断后 5、8 和 10 年计算 BMI。采用 BMI 百分位值对患者进行分类：体重不足（<第 5 百分位）、正常（第 5-85 百分位）、超重（第 85-95 百分位）和肥胖（≥第 95 百分位）。
本研究纳入了 179 例 ALL 患儿（中位年龄：59 个月）。诊断时体重不足、正常、超重/肥胖的患儿比例分别为 37%、56%和 7%；诊断后 5 年时分别为 15%、51%和 34%。诊断时的 BMI 标准差评分中位数（IQR）为-1.12（-2.40，-0.26）。诊断后 5 年[0.22（-0.83，1.24），<0.001]和 10 年[0.30（-0.69，0.99），<0.001]时，该队列的 BMI 标准差评分中位数更高。诊断后 5 年（34%，<0.001）和 10 年（26%，=0.001）时超重/肥胖者比例更高。基线 BMI 标准差评分与 5 年时（ρ=0.49，<0.001）和 10 年时（ρ=0.55，<0.001）的观察结果显著相关。
随访 10 年时，超过 25%的 ALL 患儿超重/肥胖。诊断时的 BMI 标准差评分与 10 年后的 Z 评分仍存在相关性。
