Risk Factors for the Development of Obesity in Children Surviving ALL and NHL

We investigated obesity [body mass index (BMI) > 95th percentile] and being heavy (BMI > 95th percentile) in 95 children in first remission more than 2 years after treatment for acute lymphoblastic leukemia or non-Hodgkin lymphoma seen at our institution. Height, weight and BMI at diagnosis, end of treatment and follow-up, and blood pressure at diagnosis were adjusted by z-score for age and sex. At follow-up, obesity and overweight were not more prevalent than in the general population. Median BMI z-scores rose significantly between diagnosis (0.38) and treatment end (0,62) but not during follow-up (0.70). Median weight z-scores rose significantly during, both periods (diagnosis 0.23, treatment end 0.49. and follow-up 0.68). Median height z-scores were 0.51, 0.14, and 0.16 for the same 3 time points, respectively. Repeated measures, multivariate logistic regression identified Hispanic ethnicity, younger age at diagnosis, and it positive age:weight interaction as being associated with obesity and being heavy at follow-up. There was no association with diagnosis. sex, age alone, radiation dose or field, metabolic diagnosis in patient/family, height z-score at diagnosis, duration of treatment, and systolic or diastolic blood pressure. Obesity and overweight were it combination of weight gain and height loss during treatment although weight continued to increase after treatment. We did not identify disease-related parameters associated with these effects.