This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dalton, V. K. Articles by Cohen, L. E. Search for Related Content PubMed PubMed Citation Articles by Dalton, V. K. Articles by Cohen, L. E. Social Bookmarking                            What's this?

Height and Weight in Children Treated for Acute Lymphoblastic Leukemia: Relationship to CNS Treatment

Virginia Kimball Dalton, Montse Rue, Lewis B. Silverman, Richard D. Gelber, Barbara L. Asselin, Ronald D. Barr, Luis A. Clavell, Craig A. Hurwitz, Albert Moghrabi, Yvan Samson, Marshall Schorin, Nancy J. Tarbell, Stephen E. Sallan, Laurie E. Cohen

From the Divisions of Hematology and Oncology and Endocrinology, Department of Medicine, Children’s Hospital; Departments of Pediatric Oncology and Biostatistical Science, Dana-Farber Cancer Institute; Department of Pediatrics, Harvard Medical School; and Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA; Division of Pediatric Hematology/Oncology University of Rochester Medical Center, Rochester, NY; Division of Pediatric Oncology, San Juan, Puerto Rico; Departments of Pediatric Hematology/Oncology, Maine Children’s Cancer Program and Barbara Bush Children’s Hospital at Maine Medical Center, Portland, ME; Division of Pediatric Hematology/Oncology, McMaster University, Hamilton, Ontario; Division of Hematology/Oncology, Hopital Sainte Justine, Montreal; Division of Hematology/Oncology, Le Centre Hospitalier de L’Universite Laval, Quebec City, Quebec, Canada; and Section of Pediatric Hematology Oncology, Tulane Medical School, New Orleans, LA.

Address reprint requests to Virginia M. Kimball Dalton, MS, Department of Pediatric Oncology, Dana-Farber Cancer Institute, 44 Binney St, Dana 355, Boston, MA 02115; email: Virginia_Dalton{at}dfci.harvard.edu.

Purpose: We evaluated the long-term effects of treatment on height and weight in children with acute lymphoblastic leukemia (ALL) treated with one of the following three different CNS therapies: intrathecal therapy alone, intrathecal therapy with conventional cranial radiation, or intrathecal therapy with twice-daily radiation.

Patients and Methods: Between 1987 and 1995, 618 children treated on two consecutive Dana-Farber Cancer Institute Consortium protocols for ALL were measured for height and weight at diagnosis, and approximately every 6 months thereafter. Patient height, weight, and body mass index (BMI) were converted to z scores for age and sex using the 2000 Centers for Disease Control and Prevention growth charts for the United States.

Results: Children younger than 13 years at diagnosis had a statistically significant decrease in their height z scores and an increase in their BMI z scores, regardless of whether they had received cranial radiation. Young age at diagnosis and increased chemotherapy intensity were major risk factors. Unexpectedly, there was no significant difference in long-term height between children who received radiation and those who did not.

Conclusion: Final height is compromised in survivors of ALL. The detrimental effects on height occur during therapy without the ability for long-term catch-up growth. Although patients became overweight for height, this seemed to be a result of relative height loss with normal weight gain rather than accelerated weight gain. The type of CNS treatment received did not affect changes in height, weight, or BMI.

Supported in part by grant no. CA 68484 from the National Cancer Institute, National Institutes of Health, Bethesda, MD.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				L. Diller, E. J. Chow, J. G. Gurney, M. M. Hudson, N. S. Kadin-Lottick, T. I. Kawashima, W. M. Leisenring, L. R. Meacham, A. C. Mertens, D. A. Mulrooney, et al. Chronic Disease in the Childhood Cancer Survivor Study Cohort: A Review of Published Findings J. Clin. Oncol., May 10, 2009; 27(14): 2339 - 2355. [Full Text] [PDF]

				E. G. Garmey, Q. Liu, C. A. Sklar, L. R. Meacham, A. C. Mertens, M. A. Stovall, Y. Yasui, L. L. Robison, and K. C. Oeffinger Longitudinal Changes in Obesity and Body Mass Index Among Adult Survivors of Childhood Acute Lymphoblastic Leukemia: A Report From the Childhood Cancer Survivor Study J. Clin. Oncol., October 1, 2008; 26(28): 4639 - 4645. [Abstract] [Full Text] [PDF]

				G. T. Armstrong, C. A. Sklar, M. M. Hudson, and L. L. Robison Long-Term Health Status Among Survivors of Childhood Cancer: Does Sex Matter? J. Clin. Oncol., October 1, 2007; 25(28): 4477 - 4489. [Abstract] [Full Text] [PDF]

				B. I. Razzouk, S. R. Rose, S. Hongeng, D. Wallace, M. P. Smeltzer, M. Zacher, C.-H. Pui, and M. M. Hudson Obesity in Survivors of Childhood Acute Lymphoblastic Leukemia and Lymphoma J. Clin. Oncol., April 1, 2007; 25(10): 1183 - 1189. [Abstract] [Full Text] [PDF]

				A. Moghrabi, D. E. Levy, B. Asselin, R. Barr, L. Clavell, C. Hurwitz, Y. Samson, M. Schorin, V. K. Dalton, S. E. Lipshultz, et al. Results of the Dana-Farber Cancer Institute ALL Consortium Protocol 95-01 for children with acute lymphoblastic leukemia Blood, February 1, 2007; 109(3): 896 - 904. [Abstract] [Full Text] [PDF]

				E. J. Ladas, N. Sacks, L. Meacham, D. Henry, L. Enriquez, G. Lowry, R. Hawkes, G. Dadd, and P. Rogers A Multidisciplinary Review of Nutrition Considerations in the Pediatric Oncology Population: A Perspective From Children's Oncology Group Nutr Clin Pract, August 1, 2005; 20(4): 377 - 393. [Abstract] [Full Text] [PDF]

				D. P. Waber, L. B. Silverman, L. Catania, W. Mautz, M. Rue, R. D. Gelber, D. E. Levy, M. A. Goldwasser, H. Adams, A. Dufresne, et al. Outcomes of a Randomized Trial of Hyperfractionated Cranial Radiation Therapy for Treatment of High-Risk Acute Lymphoblastic Leukemia: Therapeutic Efficacy and Neurotoxicity J. Clin. Oncol., July 1, 2004; 22(13): 2701 - 2707. [Abstract] [Full Text] [PDF]