ArticleJAMA network open2025
Overweight or Obesity and Outcomes in Children With Acute Lymphoblastic Leukemia.
Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Excess body weight at diagnosis is associated with inferior ALL outcomes in male adolescents in the ALL-BFM 2000 study.Blood neoplasia · 2026Article
- Article
- Growth and nutritional outcomes in children during the first year of cancer treatment: a scoping review with implications for child health care in low- and middle-income countries (LMICs).BMJ paediatrics open · 2026Article
- Diagnostic BMI and Induction Therapy Weight Change Associated With Hepatotoxicity in Pediatric Patients With Acute Lymphoblastic Leukemia.Cancer medicine · 2026Article
- Toxicity from asparaginase during acute lymphoblastic leukemia induction: a report from the Children's Oncology Group.Blood advances · 2026Article
- Longitudinal changes in childhood cancer survivor body mass index during early survivorship: associations with caregiver health-related parenting behaviors and survivor health behaviors.Journal of cancer survivorship : research and practice · 2026Article
- Nutritional Assessment of Children and Adolescents with Cancer in Various Resource Settings.Cancers · 2026Review
- Anthropometric indicators and risk of relapse or second malignant neoplasms in childhood cancer survivors: a scoping review.BMC public health · 2026Article
- Distinct effects of a dairy probiotic drink and physical exercise on gut microbiota in pediatric acute lymphoblastic leukemia patients in remission: a randomized clinical trial.Frontiers in microbiology · 2026Article
- Clinical evidence and biological mechanisms linking obesity to adverse outcomes in pediatric and adolescent acute lymphoblastic leukemia.Frontiers in oncology · 2026Review
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: There are conflicting data on the association of overweight or obesity with clinical outcomes in childhood acute lymphoblastic leukemia (ALL). The duration of exposure to overweight or obesity may be a better indicator of the risk of poorer outcomes. Objective: To determine the association of the duration of overweight or obesity with treatment-related toxic effects, minimal residual disease, relapse, and survival in childhood ALL. Design, Setting, and Participants: In this prospective cohort study, fluctuations in z scores of body mass index (BMI) for age from diagnosis to the end of treatment (EOT) were examined in 794 children registered on a Dana Farber Cancer Institute ALL Consortium protocol from May 31, 2005, to December 15, 2011. Height and weight were abstracted from the medical record for classification of BMI z scores at diagnosis through EOT and into survivorship. Data were analyzed from July 1 to 31, 2024. Main Outcomes and Measures: The duration of overweight or obesity was defined as having overweight or obesity at 2 or more time points and compared with having overweight or obesity at no more than 1 time point. Kaplan-Meier survival curves were generated to examine association of overweight or obesity with overall survival (OS), event-free survival (EFS), and cumulative incidence of relapse. Results: Among the 794 patients included in the analysis, the mean age at diagnosis was 6.7 (range, 1.0-17.9) years, with 441 (55.5%) being male, 136 (17.1%) Hispanic, and 553 (69.6%) non-Hispanic. The prevalence of overweight or obesity increased from 234 of 793 (29.5%) at diagnosis to 346 of 715 (48.4%) by EOT. Having overweight or obesity at baseline or developing overweight or obesity during induction was not associated with treatment-related toxic effects or higher minimal residual disease. Children with overweight or obesity at 2 or more time points experienced inferior OS (3-year OS, 93.8% vs 98.0%; P = .01), increased relapse (3-year relapse rate, 10.5% vs 5.8%; P = .02), and lower EFS (3-year EFS, 89.0% vs 93.7%; P = .02), compared with children with overweight or obesity at no more than 1 time point. Multivariable Cox proportional hazards regression models revealed an association between increased risk of death (hazard ratio [HR], 3.49; 95% CI, 1.28-9.51; P = .01) and relapse (HR, 1.92; 95% CI, 1.07-3.46; P = .03) among children with overweight or obesity at 2 or more time points. Conclusions and Relevance: In this prospective cohort study of children with ALL, longer duration of overweight or obesity was associated with lower OS and EFS and higher rates of relapse, underscoring the need for interventions targeting overweight or obesity during treatment of children with ALL.
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