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Trajectories of Obesity and Overweight Rates Among Survivors of Childhood Acute Lymphoblastic Leukemia

Megan R. Winkler

Marilyn J. Hockenberry

Kathy S. McCarthy

Susan G. Silva

leukemia, pediatric obesity, adolescent, child, preschool
ONF 2015, 42(4), E287-E293. DOI: 10.1188/15.ONF.E287-E293

Purpose/Objectives: To describe the trajectories of obesity/overweight rates by age group among survivors of childhood acute lymphoblastic leukemia (ALL) from diagnosis through several years post-therapy.

Design: Longitudinal, descriptive.

Setting: Hematology/oncology clinic in the southwestern United States.

Sample: 62 child and adolescent ALL survivors receiving treatment and follow-up care from 1999–2013.

Methods: Retrospective chart review of height, weight, and body mass index.

Main Research Variables: Annual obesity/overweight rates and developmental age groups.

Findings: Different trajectories of obesity/overweight rates existed among age groups. Forty-seven percent of adolescents met the Centers for Disease Control and Prevention criteria for obesity/overweight status at some point following diagnosis, compared to 68% of school-age and 73% of preschool children. Preschool children demonstrated the most rapid rate increase following diagnosis, with a particularly susceptible period in the years immediately following therapy. Obesity/overweight persistence was most characteristic of school-age children.

Conclusions: Important variations in rate and pattern of weight status trajectories exist by age group, demonstrating that children diagnosed with ALL during the preschool and school-age developmental years have the greatest vulnerability of developing obesity/overweight status.

Implications for Nursing: Obesity/overweight prevention efforts are greatly needed in children with ALL, and efforts should occur before ALL treatment completion in preschool and school-age children.

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