Obesity in adult survivors of childhood acute lymphoblastic leukemia: A report from the childhood cancer survivor study

Kevin C. Oeffinger, Ann C. Mertens, Charles A. Sklar, Yutaka Yasui, Thomas Fears, Marilyn Stovall, Terry Vik, Peter D. Inskip, Leslie L. Robison

Research output: Contribution to journalArticle

309 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1359-1365
Number of pages7
JournalJournal of Clinical Oncology
Volume21
Issue number7
DOIs
StatePublished - Apr 1 2003
Externally publishedYes

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Precursor Cell Lymphoblastic Leukemia-Lymphoma
Survivors
Obesity
Odds Ratio
Confidence Intervals
Siblings
Neoplasms
Radiation
Weights and Measures
Body Mass Index
Radiotherapy
Logistic Models
Delivery of Health Care
Drug Therapy
Control Groups
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Oeffinger, K. C., Mertens, A. C., Sklar, C. A., Yasui, Y., Fears, T., Stovall, M., ... Robison, L. L. (2003). Obesity in adult survivors of childhood acute lymphoblastic leukemia: A report from the childhood cancer survivor study. Journal of Clinical Oncology, 21(7), 1359-1365. https://doi.org/10.1200/JCO.2003.06.131

Obesity in adult survivors of childhood acute lymphoblastic leukemia : A report from the childhood cancer survivor study. / Oeffinger, Kevin C.; Mertens, Ann C.; Sklar, Charles A.; Yasui, Yutaka; Fears, Thomas; Stovall, Marilyn; Vik, Terry; Inskip, Peter D.; Robison, Leslie L.

In: Journal of Clinical Oncology, Vol. 21, No. 7, 01.04.2003, p. 1359-1365.

Research output: Contribution to journalArticle

Oeffinger, KC, Mertens, AC, Sklar, CA, Yasui, Y, Fears, T, Stovall, M, Vik, T, Inskip, PD & Robison, LL 2003, 'Obesity in adult survivors of childhood acute lymphoblastic leukemia: A report from the childhood cancer survivor study', Journal of Clinical Oncology, vol. 21, no. 7, pp. 1359-1365. https://doi.org/10.1200/JCO.2003.06.131
Oeffinger, Kevin C. ; Mertens, Ann C. ; Sklar, Charles A. ; Yasui, Yutaka ; Fears, Thomas ; Stovall, Marilyn ; Vik, Terry ; Inskip, Peter D. ; Robison, Leslie L. / Obesity in adult survivors of childhood acute lymphoblastic leukemia : A report from the childhood cancer survivor study. In: Journal of Clinical Oncology. 2003 ; Vol. 21, No. 7. pp. 1359-1365.
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abstract = "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.",
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AU - Yasui, Yutaka

AU - Fears, Thomas

AU - Stovall, Marilyn

AU - Vik, Terry

AU - Inskip, Peter D.

AU - Robison, Leslie L.

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N2 - 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.

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