Background: Obesity is a potential late-effect of therapies for childhood cancer. Reported prevalence rates of obesity in childhood cancer survivors are heterogenous and currently unavailable for children treated according to protocols of the German Society for Paediatric Oncology. Furthermore, risk factors for the development of obesity following childhood cancer remain largely unknown.
Methods: From a cohort of n=149 patients followed in a late-effects clinic, n=52 patients who were either survivors of ALL (n=23), M. Hodgkin (n=16), or solid tumors not involving the CNS (n=13) fulfilled the following inclusion criteria: follow-up ≥3 years after completion of therapy, no relapse, no genetic disorders, and additionally in the group of patients with solid tumors: no exposition to glucocorticoids and no amputations of extremities.
Results: Average BMI percentile at diagnosis of oncological disease was significantly higher in patients with ALL (perc. 57.6±32.7) and M. Hodgkin (perc. 51.9±302) compared to patients diagnosed with solid tumors (perc. 27.9±18.5, P<0.01). Obesity prevalence (defined as BMI >97th) increased in ALL-patients from 8% before therapy to 27% after completion of therapy and 23% after 3 years follow-up respectively. In the M. Hodgkin group, 13% were obese before therapy, and obesity prevalence remained stable throughout therapy and follow-up. No patient in the solid tumor group was affected by obesity. Patients with ALL or M. Hodgkin receiving higher doses of glucocorticoids (>15 000 or <15 000 mg/m2 BSA cortisol equivalent dose), showed a trend towards a larger increase in BMI Z-score after 3 years follow-up (Δ BMI Z-score +0.95 vs +0.61, P NS).
Conclusions: Our study confirms, that obesity is significantly more prevalent in patients with paediatric ALL compared to patients with M. Hodgkin or solid tumors. Longitudinal data demonstrates a marked increase of BMI Z-score during intensive therapy in ALL patients, which persists during midterm follow-up.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology