Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2014 Mar;133(3):e704-15.
doi: 10.1542/peds.2013-3332. Epub 2014 Feb 17.

Obesity in pediatric ALL survivors: a meta-analysis

Fang Fang Zhang  1 , Michael J Kelly, Edward Saltzman, Aviva Must, Susan B Roberts, Susan K Parsons
Affiliations
Meta-Analysis

Obesity in pediatric ALL survivors: a meta-analysis

Fang Fang Zhang et al. Pediatrics. 2014 Mar.

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.

Keywords: acute lymphoblastic leukemia; obesity; pediatric; survivors.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Search strategy flowchart.
FIGURE 2
FIGURE 2
Meta-analysis of BMI z score in survivors of pediatric ALL. dx, diagnosis.
FIGURE 3
FIGURE 3
Meta-analysis of BMI z score in survivors of pediatric ALL by interval since treatment completion (off treatment <5 years vs 5–9 years), receipt of CRT (treated with CRT versus treated with no CRT), and gender (male versus female survivors).
See this image and copyright information in PMC

References

    1. Pui CH, Evans WE. Treatment of acute lymphoblastic leukemia. N Engl J Med. 2006;354(2):166–178 - PubMed
    1. Pulte D, Gondos A, Brenner H. Trends in 5- and 10-year survival after diagnosis with childhood hematologic malignancies in the United States, 1990–2004. J Natl Cancer Inst. 2008;100(18):1301–1309 - PubMed
    1. Pui CH, Robison LL, Look AT. Acute lymphoblastic leukaemia. Lancet. 2008;371(9617):1030–1043 - PubMed
    1. Mody R, Li S, Dover DC, et al. . Twenty-five-year follow-up among survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study. Blood. 2008;111(12):5515–5523 - PMC - PubMed
    1. Oeffinger KC, Mertens AC, Sklar CA, et al. Childhood Cancer Survivor Study . Chronic health conditions in adult survivors of childhood cancer. N Engl J Med. 2006;355(15):1572–1582 - PubMed

Publication types

MeSH terms