Decreased Adult Height in Survivors of Childhood Acute Lymphoblastic Leukemia: A Report from the Childhood Cancer Survivor Study

2009 ◽  
Vol 2009 ◽  
pp. 497-499
Author(s):  
J.A. Stockman
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Childhood Cancer ◽  
Cancer Survivor ◽  
Adult Height ◽  
Lymphoblastic Leukemia ◽  
Childhood Cancer Survivor ◽  
Childhood Acute Lymphoblastic Leukemia ◽  
Childhood Cancer Survivor Study

Obesity in Adult Survivors of Childhood Acute Lymphoblastic Leukemia: A Report from the Childhood Cancer Survivor Study

2003 ◽  
Vol 21 (7) ◽  
pp. 1359-1365 ◽  
Author(s):  
Kevin C. Oeffinger ◽  
Ann C. Mertens ◽  
Charles A. Sklar ◽  
Yutaka Yasui ◽  
Thomas Fears ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Childhood Cancer ◽  
Cancer Survivor ◽  
Lymphoblastic Leukemia ◽  
Adult Survivors ◽  
Childhood Cancer Survivor ◽  
Childhood Acute Lymphoblastic Leukemia ◽  
Radiation Doses ◽  
Cranial Radiation ◽  
Childhood Cancer Survivor Study

Purpose: To determine whether adult survivors (≥ 18 years of age) of childhood acute lymphoblastic leukemia (ALL) are at increased risk for obesity and to assess patient and treatment variables that influence risk. Patients and Methods: A retrospective cohort of participants of the Childhood Cancer Survivor Study was used to compare 1,765 adult survivors of childhood ALL to 2,565 adult siblings of childhood cancer survivors. Body-mass index (BMI; kilograms per square meter), calculated from self-reported heights and weights, was used to determine the prevalence of being overweight (BMI, 25–29.9) or obese (BMI ≥ 30.0). Polytomous logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for being overweight or obese among ALL survivors relative to the sibling control group. Results: The age- and race-adjusted OR for being obese in survivors treated with cranial radiation doses ≥ 20 Gy in comparison with siblings was 2.59 for females (95% CI, 1.88 to 3.55; P < .001) and 1.86 for males (95% CI, 1.33 to 2.57; P < .001). The OR for obesity was greatest among females diagnosed at 0 to 4 years of age and treated with radiation doses ≥ 20 Gy (OR, 3.81; 95% CI, 2.34 to 5.99; P < .001). Obesity was not associated with treatment consisting of chemotherapy only or with cranial radiation doses of 10 to 19 Gy. Conclusion: Cranial radiotherapy ≥ 20 Gy is associated with an increased prevalence of obesity, especially in females treated at a young age. It is imperative that healthcare professionals recognize this risk and develop strategies to enhance weight control and encourage longitudinal follow-up.

scholarly journals Longitudinal Changes in Obesity and Body Mass Index Among Adult Survivors of Childhood Acute Lymphoblastic Leukemia: A Report From the Childhood Cancer Survivor Study

2008 ◽  
Vol 26 (28) ◽  
pp. 4639-4645 ◽  
Author(s):  
Edward G. Garmey ◽  
Qi Liu ◽  
Charles A. Sklar ◽  
Lillian R. Meacham ◽  
Ann C. Mertens ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Acute Lymphoblastic Leukemia ◽  
Childhood Cancer ◽  
Body Mass ◽  
Cancer Survivor ◽  
Comparison Group ◽  
Lymphoblastic Leukemia ◽  
Childhood Cancer Survivor ◽  
Childhood Cancer Survivor Study

Purpose We examined the rate of increase in the body mass index (BMI; kg/m2) after final height attainment in survivors of acute lymphoblastic leukemia (ALL) and a noncancer comparison group. Methods Childhood Cancer Survivor Study (CCSS) is a retrospectively ascertained cohort study that prospectively tracks the health status of adults who were diagnosed with childhood cancer between 1970 and 1986 and a comparison group of siblings. Changes in BMI from baseline enrollment to time of completion of follow-up (mean interval, 7.8 years) were calculated for 1,451 ALL survivors (mean age, 32.3 years at follow-up) and 2,167 siblings of childhood cancer survivors (mean age, 35.9 years). Results The mean BMI of the CCSS sibling comparison group increased with age (women, 0.25 units/yr, 95% CI, 0.22 to 0.28 units; men, 0.23 units/yr, 95% CI, 0.20 to 0.25 units). Compared with CCSS siblings, ALL survivors who were treated with cranial radiation therapy (CRT) had a significantly greater increase in BMI (women, 0.41 units/yr, 95% CI, 0.37 to 0.45 units; men, 0.29 units/yr; 95% CI, 0.26 to 0.32 units). The rate of BMI increase was not significantly increased for ALL survivors who were treated with chemotherapy alone. Younger age at CRT exposure significantly modified risk. Conclusion CRT used in the treatment of childhood ALL is associated with a greater rate of increasing BMI, particularly among women treated with CRT during the first decade of life. Health care professionals should be aware of this risk and interventions to reduce or manage weight gain are essential in this high-risk population.

Genetic Variation in the Leptin Receptor Gene and Obesity in Survivors of Childhood Acute Lymphoblastic Leukemia: A Report From the Childhood Cancer Survivor Study

2004 ◽  
Vol 22 (17) ◽  
pp. 3558-3562 ◽  
Author(s):  
Julie A. Ross ◽  
Kevin C. Oeffinger ◽  
Stella M. Davies ◽  
Ann C. Mertens ◽  
Erica K. Langer ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Childhood Cancer ◽  
Cancer Survivor ◽  
Leptin Receptor ◽  
Lymphoblastic Leukemia ◽  
Childhood Acute Lymphoblastic Leukemia ◽  
Childhood All ◽  
Female Survivors ◽  
Cranial Radiation ◽  
Childhood Cancer Survivor Study

Purpose Overweight (body mass index [BMI] 25 to 29 kg/m2) and obesity (BMI ≥ 30 kg/m2) frequently follow treatment for childhood acute lymphoblastic leukemia (ALL). Recent studies suggest that risk is most apparent in females treated with cranial radiation at a younger age. Because radiation at a young age may affect the hypothalamus causing leptin receptor insensitivity, we hypothesized that a polymorphism in the leptin receptor (LEPR) gene, Gln223Arg, might influence susceptibility to obesity in survivors of childhood ALL. Patients and Methods We genotyped 600 non-Hispanic white adult ALL survivors enrolled onto the Childhood Cancer Survivor Study. BMI was compared between those with two copies of the Arg allele to those who had at least one copy of the Gln allele. Results Female survivors with BMI ≥ 25 kg/m2 were more likely Arg homozygous than those with BMI less than 25 kg/m2 (24% v 12%; P = .007). This difference was not observed in males. Moreover, among females treated with ≥ 20 Gy cranial radiation, Arg/Arg individuals had six times higher odds of having BMI ≥ 25 kg/m2 (95% CI, 2.1 to 22.0) than those with a Gln allele (P = .04 for interaction). Conclusion LEPR polymorphism may influence obesity in female survivors of childhood ALL, particularly those exposed to cranial radiation. Because obesity is associated with increased morbidity and mortality in later life, identification of children at high risk might allow for early targeted interventions.

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