Evaluation of changes in random blood glucose and body mass index during and after completion of chemotherapy in children with acute lymphoblastic leukemia

Bang, Kyongwon; Seo, Seung Beom; Lee, Jae Woo; Jang, Pil‐Sang; Jung, Min Ho; Chung, Nack‐Gyun; Cho, Bin; Jeong, Dae-Chul; Suh, Byung‐Kyu; Kim, Hack-Ki

doi:10.3345/kjp.2012.55.4.121

Cited by 8 publications

(11 citation statements)

References 20 publications

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“…Again, the elimination of cranial irradiation in many patients may aid in minimizing these toxicities. In our study of patients treated with dexamethasone-based chemotherapy and without cranial irradiation, random glucose and body mass index decreased significantly at 12 months posttreatment completion compared to values measured during chemotherapy76). Although limited by short-term follow-up, our study did not find evidence for either long-term glucose intolerance or potential obesity during the aftermath of therapy for patients treated without allogeneic HCT and cranial irradiation.…”

Section: Long-term Effects Of Treatmentcontrasting

confidence: 70%

Prognostic factors and treatment of pediatric acute lymphoblastic leukemia

Lee

Cho

2017

Korean J Pediatr

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The event-free survival (EFS) for pediatric acute lymphoblastic leukemia (ALL) has shown remarkable improvement in the past several decades. In Korea also, a recent study showed 10-year EFS of 78.5%. Much of the improved outcome for pediatric ALL stems from the accurate identification of prognostic factors, the designation of risk group based on these factors, and treatment of appropriate duration and intensity according to risk group, done within the setting of cooperative clinical trials. The schema of first-line therapy for ALL remains mostly unchanged, although many groups have now reported on the elimination of cranial irradiation in all patients with low rates of central nervous system relapse. Specific high risk subgroups, such as Philadelphia chromosome-positive (Ph+) ALL and infant ALL continue to have significantly lower survival than other ALL patients. The introduction of tyrosine kinase inhibitors into therapy has led to enhanced outcome for Ph+ ALL patients. Infant ALL patients, particularly those with MLL rearrangements, continue to have poor outcome, despite treatment intensification including allogeneic hematopoietic cell transplantation. Relapsed ALL is a leading cause of mortality in pediatric cancer. Recent advances in immunotherapy targeting the CD19 of the ALL blast have shown remarkable efficacy in some of these relapsed and refractory patients. With improved survival, much of the current focus is on decreasing the long-term toxicities of treatment.

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Section: Long-term Effects Of Treatmentcontrasting

confidence: 70%

Prognostic factors and treatment of pediatric acute lymphoblastic leukemia

Lee

Cho

2017

Korean J Pediatr

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“…Sixteen studies provided data for mean and SD of BMI z‐score or percentile for at least two time points during and after treatment and were included in the meta‐analysis (Table ). Baseline BMI z‐scores ranged from −0.64 to 0.64 across studies.…”

Section: Resultsmentioning

confidence: 99%

“…Among the 16 included studies, eight [] explicitly reported the mean BMI z‐score for the overall cohort, one reported the mean BMI percentile, which was converted to BMI z‐score based on the standard normal curve, and we obtained the mean BMI z‐score directly from authors in one study . For the remaining six studies, the mean BMI z‐score was calculated as a weighted average based on subgroup values (using sample size as weights) in five studies , or was estimated based on median BMI z‐score in one study .…”

Section: Methodsmentioning

confidence: 99%

“…For the remaining six studies, the mean BMI z‐score was calculated as a weighted average based on subgroup values (using sample size as weights) in five studies , or was estimated based on median BMI z‐score in one study . For standard deviation (SD) of the BMI z‐score, nine studies explicitly reported the standard deviation/error or confidence interval of the BMI z‐score or percentile, and we obtained SD directly from authors in one study . For the remaining six studies, the SD was either calculated as a pooled standard deviation based on subgroup values assuming equal variance in five studies , or estimated from median and range in one study using methods described by Hozo et al .…”

Section: Methodsmentioning

confidence: 99%

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Growth patterns during and after treatment in patients with pediatric ALL: A meta‐analysis

Zhang

Liu

PhD

et al. 2015

Pediatric Blood & Cancer

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Background Survivors of pediatric acute lymphoblastic leukemia (ALL) have a significantly higher body mass index (BMI) than their peers. Understanding the critical time periods in which patients with pediatric ALL are vulnerable to unhealthy weight gain will lay the groundwork for developing effectively timed interventions. Procedure We determined the growth patterns of patients with pediatric ALL during and after treatment through the conduct of a systematic review and meta-analysis. A search of MEDLINE, Scopus, and Web of Science was performed from its inception through May 2014. Studies met the inclusion criteria if they included at least 10 patients of pediatric ALL, and longitudinally assessed BMI at diagnosis and at least one time point after diagnosis Results Twenty-one studies met the inclusion criteria for the systematic review and 16 were included in meta-analysis. The mean increase in BMI z-score during treatment in 1,514 patients with pediatric ALL was 0.81 (95% CI: 0.25–1.38). Specifically, patients experienced substantial weight gain in early treatment (Δ=0.41, 95% CI: −0.34, 1.17) and again during maintenance (Δ=0.34, 95% CI: −0.22, 0.90). The mean increase in BMI z-score ranged between 0.52 and 0.89 beyond treatment completion. Subgroup analyses found unhealthy weight gain occurred regardless of patients’ receipt of cranial radiation therapy, sex, and weight status at diagnosis. Conclusions Patients with pediatric ALL experience unhealthy weight gain early in treatment, and increases in weight are maintained beyond treatment completion. Preventing early onset of obesity is a priority for improving the care and outcomes for patients with pediatric ALL.

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“…These survivors had completed treatment within 10 years at the time of study evaluation. 8,12,13,16,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] Only 2 studies 14,40 examined BMI z score assessed $10 years after the completion of treatment (ie, off treatment $10 years). Because neither study reported SD/SE of the BMI z score, the meta-analysis did not include survivors who were off treatment beyond 10 years.…”

Section: Discussionmentioning

confidence: 99%

Obesity in Pediatric ALL Survivors: A Meta-Analysis

et al. 2014

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Obesity in Pediatric ALL Survivors: A Meta-Analysis abstract BACKGROUND AND OBJECTIVE: Previous studies of survivors of pediatric acute lymphoblastic leukemia (ALL) have drawn heterogeneous conclusions regarding the prevalence of obesity and risk factors for developing obesity in pediatric ALL survivors. We sought to determine the prevalence of obesity in pediatric ALL survivors and examine risk factors for obesity through a systematic review and meta-analysis. METHODS:A MEDLINE search was performed from its inception through 2013. Studies met the inclusion criteria if they (1) included at least 10 survivors of pediatric ALL; (2) assessed the prevalence or indicators of obesity; and (3) compared obesity among ALL survivors to a reference population or external control group. Extracted data included patient and treatment characteristics, study design, population used for comparison, and prevalence of obesity. RESULTS:Forty-seven studies met the inclusion criteria. Despite significant heterogeneity among the studies (I 2 = 96%), the mean BMI z score in 1742 pediatric ALL survivors was 0.83 (95% confidence interval: 0.60-1.06), which corresponds to the 80th BMI percentile, indicating a significantly higher BMI in pediatric ALL survivors than the reference population. Subgroup analyses found a high prevalence of obesity in ALL survivors regardless of survivors' receipt of cranial irradiation, gender, or age at diagnosis. CONCLUSIONS:Obesity is prevalent in pediatric ALL survivors and is independent of patient-and treatment-related characteristics. Clinicians need to screen for obesity and its associated health conditions early in survivorship. Pediatrics 2014;133:e704-e715

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Evaluation of changes in random blood glucose and body mass index during and after completion of chemotherapy in children with acute lymphoblastic leukemia

Cited by 8 publications

References 20 publications

Prognostic factors and treatment of pediatric acute lymphoblastic leukemia

Prognostic factors and treatment of pediatric acute lymphoblastic leukemia

Growth patterns during and after treatment in patients with pediatric ALL: A meta‐analysis

Obesity in Pediatric ALL Survivors: A Meta-Analysis

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