The negative impact of being underweight and weight loss on survival of children with acute lymphoblastic leukemia

Hoed, Marissa A. H. den; Pluijm, Saskia M. F.; Groot-Kruseman, Hester A. de; Winkel, M.L. te; Fiocco, M.; Akker, Erica L T van den; Hoogerbrugge, Peter M.; Berg, Henk van den; Leeuw, Jan A.; Bruin, Marrie C.A.; Bresters, Dorine; Veerman, A. J. P.; Pieters, Rob; Heuvel‐Eibrink, Marry M. van den

doi:10.3324/haematol.2014.110668

Cited by 42 publications

(38 citation statements)

References 48 publications

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“…7 Loss of body mass index and FFM decreased overall survival in children with cancer. 8 Thus, measurement of body composition, including FFM and FM determination, can provide valuable information for patient assessment.…”

Section: Introductionmentioning

confidence: 99%

Body composition during growth in children: limitations and perspectives of bioelectrical impedance analysis

et al. 2015

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There are a number of differences between the body composition of children and adults. Body composition measurements in children are inherently challenging, because of the rapid growth-related changes in height, weight, fat-free mass (FFM) and fat mass (FM), but they are fundamental for the quality of the clinical follow-up. All body composition measurements for clinical use are 'indirect' methods based on assumptions that do not hold true in all situations or subjects. The clinician must primarily rely on two-compartment models (that is, FM and FFM) for routine determination of body composition of children. Bioelectrical impedance analysis (BIA) is promising as a bedside method, because of its low cost and ease of use. This paper gives an overview of the differences in body composition between adults and children in order to understand and appreciate the difference in body composition during growth. It further discusses the use and limitations of BIA/bioelectrical spectroscopy (BIA/BIS) in children. Single-frequency and multi-frequency BIA equations must be refined to better reflect the body composition of children of specific ethnicities and ages but will require development and cross-validation. In conclusion, recent studies suggest that BIA-derived body composition and phase angle measurements are valuable to assess nutritional status and growth in children, and may be useful to determine baseline measurements at hospital admission, and to monitor progress of nutrition treatment or change in nutritional status during hospitalization.

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Section: Introductionmentioning

confidence: 99%

Body composition during growth in children: limitations and perspectives of bioelectrical impedance analysis

et al. 2015

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“…We only had information on BMI at diagnosis and therefore could not investigate effect of weight change on outcome, a factor which has been associated with outcome in pediatric acute lymphoblastic leukemia. [32][33][34] The North American cohort was created for studies on infectious complications in pediatric AML, 10,[35][36][37] and not for studies on outcome and therefore follow-up is short for some patients. The patients included in the study were treated within a rather large timeframe (1995-2016) on 17 different protocols, which makes the cohort relatively heterogeneous.…”

Section: Discussionmentioning

confidence: 99%

Associations between pretherapeutic body mass index, outcome, and cytogenetic abnormalities in pediatric acute myeloid leukemia

Løhmann

Asdahl

Abrahamsson³

et al. 2019

Cancer Medicine

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Background Associations between body mass index (BMI), outcome, and leukemia‐related factors in children with acute myeloid leukemia (AML) remain unclear. We investigated associations between pretherapeutic BMI, cytogenetic abnormalities, and outcome in a large multinational cohort of children with AML. Methods We included patients, age 2‐17 years, diagnosed with de novo AML from the five Nordic countries (2004‐2016), Hong Kong (2007‐2016), the Netherlands and Belgium (2010‐2016), and Canada and USA (1995‐2012). BMI standard deviations score for age and sex was calculated and categorized according to the World Health Organization. Cumulative incidence functions, Kaplan‐Meier estimator, Cox regression, and logistic regression were used to investigate associations. Results In total, 867 patients were included. The median age was 10 years (range 2‐17 years). At diagnosis, 32 (4%) were underweight, 632 (73%) were healthy weight, 127 (15%) were overweight, and 76 (9%) were obese. There was no difference in relapse risk, treatment‐related mortality or overall mortality across BMI groups. The frequency of t(8;21) and inv(16) increased with increasing BMI. For obese patients, the sex, age, and country adjusted odds ratio of having t(8;21) or inv(16) were 1.9 (95% confidence interval (CI) 1.1‐3.4) and 2.8 (95% CI 1.3‐5.8), respectively, compared to healthy weight patients. Conclusions This study did not confirm previous reports of associations between overweight and increased treatment‐related or overall mortality in children. Obesity was associated with a higher frequency of t(8;21) and inv(16). AML cytogenetics appear to differ by BMI status.

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“…Increase in LM may help in improving the health status by decreasing obesity while a decrease in LM is associated with an adverse outcome. [23]…”

Section: Discussionmentioning

confidence: 99%

Relationship of lean mass and obesity in Indian urban children and adolescents

Garg

Marwaha

Mahalle

et al. 2016

Indian J Endocr Metab

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Background:The association of obesity and lean mass (LM) has not been examined well in children and adolescents, and it remains controversial.Objective:The objective of this study was to evaluate the relationship of body mass index (BMI) categories and regional obesity with total and regional LM in children and adolescents.Methods:A total of 1408 children and adolescents (boys 58.9%; girls 41.1%) divided according to BMI (normal weight 79.5%, overweight 16.0%, and obese 4.5%) were included in this cross-sectional study. Total and regional LM and fat mass were measured by DXA. Leg and arm fat-to-total fat ratio (LATR) indicative of subcutaneous fat and trunk fat-to-total fat ratio (TTR), an indicator of visceral fat, were calculated.Results:Mean age of the study population was 13.2 ± 2.7 years (boys - 13.0 ± 2.7; girls - 13.4 ± 2.8 years). Total LM (TLM) and its regional distribution were higher in overweight and obese groups when compared with those with normal BMI in both genders. TLM was comparable between overweight and obese in both genders. TLM per unit of fat progressively decreased from normal to obese categories. The difference in LM per unit fat between BMI categories persisted after adjustment for age, height, and sexual maturity score. TLM increased across the quartiles of TTR, but decreased with an increment in subcutaneous fat (quartiles of LATR).Conclusions:Obese children and adolescents apparently have higher LM than normal BMI children, but have lower LM per unit of fat. Subcutaneous fat had a negative impact and visceral fat had a positive impact on TLM.

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The negative impact of being underweight and weight loss on survival of children with acute lymphoblastic leukemia

Cited by 42 publications

References 48 publications

Body composition during growth in children: limitations and perspectives of bioelectrical impedance analysis

Body composition during growth in children: limitations and perspectives of bioelectrical impedance analysis

Associations between pretherapeutic body mass index, outcome, and cytogenetic abnormalities in pediatric acute myeloid leukemia

Relationship of lean mass and obesity in Indian urban children and adolescents

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