Increased risk for death and relapse seen for children with overweight, obesity at two or more time points
By Elana Gotkine HealthDay Reporter
TUESDAY, May 20, 2025 (HealthDay News) — For children with acute lymphoblastic leukemia (ALL), longer duration of overweight or obesity is associated with lower overall and event-free survival, according to a study published online May 14 in JAMA Network Open.
Elena J. Ladas, Ph.D., R.D., from the Columbia University Irving Medical Center in New York City, and colleagues examined the association of the duration of overweight or obesity with treatment-related toxic effects, minimal residual disease, relapse, and survival in childhood ALL in a prospective study. Fluctuations in z scores of body mass index for age from diagnosis to end of treatment (EOT) were examined in 794 children (mean age at diagnosis, 6.7 years).
The researchers found an increase in the prevalence of overweight or obesity from diagnosis to EOT, from 29.5 to 48.4 percent. There was no association for having overweight or obesity at baseline or developing overweight or obesity during induction with treatment-related toxic effects or higher minimal residual disease. Compared with children with overweight or obesity at no more than one time point, those with overweight or obesity at two or more time points experienced inferior overall survival, increased relapse, and lower event-free survival. Among children with overweight or obesity at two or more time points, there was an association with an increased risk for death and relapse (hazard ratios, 3.49 and 1.92, respectively).
“Treatment for obesity is evolving, and our study highlights the importance of working closely with children and their families to provide comprehensive care — whether by treating obesity during therapy or preventing it altogether,” Ladas said in a statement. “Our findings support a new clinical approach that includes proactive nutrition therapy for children undergoing treatment for acute lymphoblastic leukemia.”
Several authors disclosed ties to the pharmaceutical industry.
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