Abstract
The frequency and pattern of obesity in survivors of acute lymphoblastic leukaemia (ALL) was examined in a retrospective analysis of height and weight at zero, two, and four years from diagnosis in 40 children (19 boys and 21 girls). The children had been treated according to the Medical Research Council protocols UKALL VIII and X, both of which included cranial radiotherapy at a dose of 1800 cGy. Body mass index (BMI), determined as weight/height, was used as a measure of fatness. The BMI Z scores were calculated for each patient from standard tables. The ALL group was compared with a control group of 18 age matched children who had received chemotherapy but no radiotherapy. Changes in BMI between diagnosis and two and four years later were analysed by paired t tests. Mean BMI Z scores at diagnosis were similar between ALL boys, ALL girls, and the control group. Two years after diagnosis the ALL group, particularly the girls, showed a significant increase in BMI. By four years BMI had decreased slightly in the ALL boys, but had increased still further in the ALL girls with 57% having BMI Z scores greater than 2. In the control group BMI increased, but not significantly, at two and four years. It is concluded that the obesity seen in patients treated for ALL is more pronounced in girls than boys, and that cranial irradiation is an important factor.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Crowne E. C., Moore C., Wallace W. H., Ogilvy-Stuart A. L., Addison G. M., Morris-Jones P. H., Shalet S. M. A novel variant of growth hormone (GH) insufficiency following low dose cranial irradiation. Clin Endocrinol (Oxf) 1992 Jan;36(1):59–68. doi: 10.1111/j.1365-2265.1992.tb02903.x. [DOI] [PubMed] [Google Scholar]
- Kirk J. A., Raghupathy P., Stevens M. M., Cowell C. T., Menser M. A., Bergin M., Tink A., Vines R. H., Silink M. Growth failure and growth-hormone deficiency after treatment for acute lymphoblastic leukaemia. Lancet. 1987 Jan 24;1(8526):190–193. doi: 10.1016/s0140-6736(87)90004-3. [DOI] [PubMed] [Google Scholar]
- Leiper A. D., Stanhope R., Kitching P., Chessells J. M. Precocious and premature puberty associated with treatment of acute lymphoblastic leukaemia. Arch Dis Child. 1987 Nov;62(11):1107–1112. doi: 10.1136/adc.62.11.1107. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Moëll C., Garwicz S., Westgren U., Wiebe T., Albertsson-Wikland K. Suppressed spontaneous secretion of growth hormone in girls after treatment for acute lymphoblastic leukaemia. Arch Dis Child. 1989 Feb;64(2):252–258. doi: 10.1136/adc.64.2.252. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Neglia J. P., Meadows A. T., Robison L. L., Kim T. H., Newton W. A., Ruymann F. B., Sather H. N., Hammond G. D. Second neoplasms after acute lymphoblastic leukemia in childhood. N Engl J Med. 1991 Nov 7;325(19):1330–1336. doi: 10.1056/NEJM199111073251902. [DOI] [PubMed] [Google Scholar]
- Parkin D. M., Stiller C. A., Draper G. J., Bieber C. A. The international incidence of childhood cancer. Int J Cancer. 1988 Oct 15;42(4):511–520. doi: 10.1002/ijc.2910420408. [DOI] [PubMed] [Google Scholar]
- Rolland-Cachera M. F., Cole T. J., Sempé M., Tichet J., Rossignol C., Charraud A. Body Mass Index variations: centiles from birth to 87 years. Eur J Clin Nutr. 1991 Jan;45(1):13–21. [PubMed] [Google Scholar]
- Shalet S. M., Price D. A., Beardwell C. G., Jones P. H., Pearson D. Normal growth despite abnormalities of growth hormone secretion in children treated for acute leukemia. J Pediatr. 1979 May;94(5):719–722. doi: 10.1016/s0022-3476(79)80137-7. [DOI] [PubMed] [Google Scholar]
- Stiller C. A., Bunch K. J. Trends in survival for childhood cancer in Britain diagnosed 1971-85. Br J Cancer. 1990 Nov;62(5):806–815. doi: 10.1038/bjc.1990.383. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Swift P. G., Kearney P. J., Dalton R. G., Bullimore J. A., Mott M. G., Savage D. C. Growth and hormonal status of children treated for acute lymphoblastic leukaemia. Arch Dis Child. 1978 Nov;53(11):890–894. doi: 10.1136/adc.53.11.890. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zee P., Chen C. H. Prevalence of obesity in children after therapy for acute lymphoblastic leukemia. Am J Pediatr Hematol Oncol. 1986 Winter;8(4):294–299. doi: 10.1097/00043426-198624000-00005. [DOI] [PubMed] [Google Scholar]