Child Health Nursing Research

Korean Academy of Child Health Nursing (한국아동간호학회)
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Weight status in survivors of childhood acute lymphocytic leukemia in South Korea: a retrospective descriptive study

  • Yeongseon Kim (College of Nursing, Seoul National University) ;
  • Kyung-Sook Bang (College of Nursing.The Research Institute of Nursing Science, Seoul National University)
  • Received : 2023.08.10
  • Accepted : 2023.09.25
  • Published : 2023.10.31
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Abstract

Purpose: This study investigated weight status in survivors of childhood acute lymphocytic leukemia (ALL) and identified related factors. Methods: A retrospective review of the electronic medical records of survivors of childhood ALL (n=230) was conducted. We analyzed the survivors' characteristics, including sex, age, weight status at diagnosis, central nervous system involvement, risk classification, length of treatment, radiation therapy, and hematopoietic stem cell transplantation. Analysis of variance and the chi-squared test were applied to investigate influencing factors. Results: The weight status distribution was as follows: 23 individuals (10.0%) were classified as underweight, 151 individuals (65.7%) were healthy weight, and 56 individuals (24.3%) were overweight/obese. Age at diagnosis (F=10.03, p<.001), weight status at diagnosis (x2=43.41, p<.001), and risk classification (F=10.98, p=0.027) showed significant differences among the weight status groups. Survivors who were older at diagnosis and those in the very high-risk category had a higher likelihood of experiencing underweight status during their survivorship, while survivors who were overweight/obese at diagnosis were more likely to remain overweight/obese at the time of survival. Conclusion: Considering the potential health implications related to an unhealthy weight status in survivors of ALL, it is imperative to undertake early identification and implement interventions for at-risk individuals.

Keywords

References

  1. Korea Central Cancer Registry. Annual report of cancer statistics in Korea in 2020. National Cancer Center; 2022. p. 126, 184.
  2. Bhakta N, Liu Q, Ness KK, Baassiri M, Eissa H, Yeo F, et al. The cumulative burden of surviving childhood cancer: an initial report from the St Jude Lifetime Cohort Study (SJLIFE). Lancet. 2017;390(10112):2569-2582. https://doi.org/10.1016/S0140-6736(17)31610-0
  3. Geenen MM, Cardous-Ubbink MC, Kremer LC, van den Bos C, van der Pal HJ, Heinen RC, et al. Medical assessment of adverse health outcomes in long-term survivors of childhood cancer. Journal of the American Medical Association. 2007;297(24):2705-2715. https://doi.org/10.1001/jama.297.24.2705
  4. Hudson MM, Ness KK, Gurney JG, Mulrooney DA, Chemaitilly W, Krull KR, et al. Clinical ascertainment of health outcomes among adults treated for childhood cancer. Journal of the American Medical Association. 2013;309(22):2371-2381. https://doi.org/10.1001/jama.2013.6296
  5. Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, et al.; Childhood Cancer Survivor Study. Chronic health conditions in adult survivors of childhood cancer. New England Journal of Medicine. 2006;355(15):1572-1582. https://doi.org/10.1056/nejmsa060185
  6. Phillips SM, Padgett LS, Leisenring WM, Stratton KK, Bishop K, Krull KR, et al. Survivors of childhood cancer in the United States: prevalence and burden of morbidity. Cancer Epidemiology, Biomarkers & Prevention. 2015;24(4):653-663. https://doi.org/10.1158/1055-9965.EPI-14-1418
  7. Dobner J, Kaser S. Body mass index and the risk of infection - From underweight to obesity. Clinical Microbiology and Infection. 2018;24:24-28. https://doi.org/10.1016/j.cmi.2017.02.013
  8. Boutari C, Pappas PD, Mintziori G, Nigdelis MP, Athanasiadis L, Goulis DG, et al. The effect of underweight on female and male reproduction. Metabolism. 2020;107:154229. https://doi.org/10.1016/j.metabol.2020.154229
  9. Park D, Lee JH, Han S. Underweight: another risk factor for cardiovascular disease?: a cross-sectional 2013 Behavioral Risk Factor Surveillance System (BRFSS) study of 491,773 individuals in the USA. Medicine (Baltimore). 2017;96(48):e8769. https://doi.org/10.1097/MD.0000000000008769
  10. Han S, Park J, Nah S, Jang HD, Han K, Hong JY. Severity of underweight and risk of fracture: a Korean nationwide populationbased cohort study. Scientific Reports. 2022;12(1):10153. https://doi.org/10.1038/s41598-022-14267-x
  11. Jee SH, Sull JW, Park J, Lee SY, Ohrr H, Guallar E, et al. Body-mass index and mortality in Korean men and women. New England Journal of Medicine. 2006;355(8):779-787. https://doi.org/10.1056/NEJMoa054017
  12. Kwon H, Yun JM, Park JH, Cho BL, Han K, Joh HK, et al. Incidence of cardiovascular disease and mortality in underweight individuals. Journal of Cachexia, Sarcopenia and Muscle. 2021;12(2):331-338. https://doi.org/10.1002/jcsm.12682
  13. Ali SM, Lindstrom M. Socioeconomic, psychosocial, behavioural, and psychological determinants of BMI among young women: differing patterns for underweight and overweight/obesity. European Journal of Public Health. 2006;16(3):325-331. https://doi.org/10.1093/eurpub/cki187
  14. Brewis AA, Han SY, SturtzSreetharan CL. Weight, gender, and depressive symptoms in South Korea. American Journal of Human Biology. 2017;29(4):e22972. https://doi.org/10.1002/ajhb.22972
  15. Andolina JR, Dilley K. Anthracycline-induced cardiac toxicity more likely in underweight childhood cancer survivors. Journal of Pediatric Hematology/Oncology. 2010;32(5):411-415. https://doi.org/10.1097/mph.0b013e3181dccd37
  16. Tonorezos ES, Meacham LR, Chou JF, Moskowitz CS, Leisenring WM, Friedman DN, et al. Increased late mortality in underweight survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Journal of Clinical Oncology. 2017;35(5 Suppl):110. https://doi.org/10.1200/JCO.2017.35.5_suppl.110
  17. Petrelli F, Cortellini A, Indini A, Tomasello G, Ghidini M, Nigro O, et al. Association of obesity with survival outcomes in patients with cancer: a systematic review and meta-analysis. JAMA Network Open. 2021;4(3):e213520. https://doi.org/10.1001/jamanetworkopen.2021.3520
  18. Zhang FF, Kelly MJ, Saltzman E, Must A, Roberts SB, Parsons SK. Obesity in pediatric ALL survivors: a meta-analysis. Pediatrics. 2014;133(3):e704-e715. https://doi.org/10.1542/peds.2013-3332
  19. Nam GE, Kaul S, Wu YP, Nelson RE, Wright J, Fluchel MN, et al. A meta-analysis of body mass index of adolescent and adult survivors of pediatric acute lymphoblastic leukemia. Journal of Cancer Survivorship. 2015;9(3):412-421. https://doi.org/10.1007/s11764-014-0415-x
  20. Nottage KA, Ness KK, Li C, Srivastava D, Robison LL, Hudson MM. Metabolic syndrome and cardiovascular risk among long-term survivors of acute lymphoblastic leukaemia - From the St. Jude Lifetime Cohort. British Journal of Haematology. 2014;165(3):364-374. https://doi.org/10.1111/bjh.12754
  21. Odame I, Reilly JJ, Gibson BE, Donaldson MD. Patterns of obesity in boys and girls after treatment for acute lymphoblastic leukaemia. Archives of Disease in Childhood. 1994;71(2):147-149. https://doi.org/10.1136/adc.71.2.147
  22. Razzouk BI, Rose SR, Hongeng S, Wallace D, Smeltzer MP, Zacher M, et al. Obesity in survivors of childhood acute lymphoblastic leukemia and lymphoma. Journal of Clinical Oncology. 2007;25(10):1183-1189. https://doi.org/10.1200/JCO.2006.07.8709
  23. Brown AL, Lupo PJ, Danysh HE, Okcu MF, Scheurer ME, Kamdar KY. Prevalence and predictors of overweight and obesity among a multiethnic population of pediatric acute lymphoblastic leukemia survivors: a cross-sectional assessment. Journal of Pediatric Hematology/Oncology. 2016;38(6):429-436. https://doi.org/10.1097/MPH.0000000000000555
  24. Asner S, Ammann RA, Ozsahin H, Beck-Popovic M, von der Weid NX. Obesity in long-term survivors of childhood acute lymphoblastic leukemia. Pediatric Blood & Cancer. 2008;51(1):118-122. https://doi.org/10.1002/pbc.21496
  25. Zhang FF, Rodday AM, Kelly MJ, Must A, MacPherson C, Roberts SB, et al. Predictors of being overweight or obese in survivors of pediatric acute lymphoblastic leukemia (ALL). Pediatric Blood & Cancer. 2014;61(7):1263-1269. https://doi.org/10.1002/pbc.24960
  26. Gance-Cleveland B, Linton A, Arbet J, Stiller D, Sylvain G. Predictors of overweight and obesity in childhood cancer survivors. Journal of Pediatric Oncology Nursing. 2020;37(3):154-162. https://doi.org/10.1177/1043454219897102
  27. Garmey EG, Liu Q, Sklar CA, Meacham LR, Mertens AC, Stovall MA, et al. Longitudinal changes in obesity and body mass index among adult survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study. Journal of Clinical Oncology. 2008;26(28):4639-4645. https://doi.org/10.1200/jco.2008.16.3527
  28. Oeffinger KC, Mertens AC, Sklar CA, Yasui Y, Fears T, Stovall M, et al.; Childhood Cancer Survivor Study. Obesity in adult survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study. Journal of Clinical Oncology. 2003;21(7):1359-1365. https://doi.org/10.1200/jco.2003.06.131
  29. Shin HK, Choi YJ, Lee YH, Shin JH, Yang S. Prevalence of the components of metabolic syndrome in childhood cancer survivors. Clinical Pediatric Hematology-Oncology. 2014;21(1):23-28. https://doi.org/10.15264/cpho.2014.21.1.23
  30. Sohn YB, Kim SJ, Park SW, Kim SH, Cho SY, Lee SH, et al. The metabolic syndrome and body composition in childhood cancer survivors. Korean Journal of Pediatrics. 2011;54(6):253-259. https://doi.org/10.3345/kjp.2011.54.6.253
  31. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP; STROBE Initiative. Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. British Medical Journal. 2007;335(7624):806-808. https://doi.org/10.1136/bmj.39335.541782.AD
  32. Kim JH, Yun S, Hwang S, Shim JO, Chae HW, Lee YJ, et al. The 2017 Korean National Growth Charts for children and adolescents: development, improvement, and prospects. Korean Journal of Pediatrics. 2018;61(5):135-149. https://doi.org/10.3345/kjp.2017.60
  33. Smith M, Arthur D, Camitta B, Carroll AJ, Crist W, Gaynon P, et al. Uniform approach to risk classification and treatment assignment for children with acute lymphoblastic leukemia. Journal of Clinical Oncology. 1996;14(1):18-24. https://doi.org/10.1200/jco.1996.14.1.18
  34. Meacham LR, Gurney JG, Mertens AC, Ness KK, Sklar CA, Robison LL, et al. Body mass index in long-term adult survivors of childhood cancer: A report of the Childhood Cancer Survivor Study. Cancer. 2005;103(8):1730-1739. https://doi.org/10.1002/cncr.20960
  35. Belle FN, Weiss A, Schindler M, Goutaki M, Bochud M, Zimmermann K, et al. Overweight in childhood cancer survivors: the Swiss Childhood Cancer Survivor Study. American Journal of Clinical Nutrition. 2018;107(1):3-11. https://doi.org/10.1093/ajcn/nqx006
  36. Korea Disease Control and Prevention Agency (KDCA). Korea Health Statistics 2021: Korea National Health and Nutrition Examination Survey (KNHANES VIII-3) [Internet]. 2022 [cited 2023 June 5]. Available from: https://knhanes.kdca.go.kr/knhanes/
  37. Dupuis LL, Lu X, Mitchell HR, Sung L, Devidas M, Mattano LA Jr, et al. Anxiety, pain, and nausea during the treatment of standard-risk childhood acute lymphoblastic leukemia: a prospective, longitudinal study from the Children's Oncology Group. Cancer. 2016;122(7):1116-1125. https://doi.org/10.1002/cncr.29876
  38. Freedman JL, Faerber J, Kang TI, Dai D, Fisher BT, Huang YS, et al. Predictors of antiemetic alteration in pediatric acute myeloid leukemia. Pediatric Blood & Cancer. 2014;61(10):1798-1805. https://doi.org/10.1002/pbc.25108
  39. Ministry of Health and Welfare (MOHW). Cancer survivor support service guide [Internet]. 2023 [cited 2023 June 5]. Available from: https://www.mohw.go.kr/react/jb/sjb0601vw.jsp?PAR_MENU_ID=03&MENU_ID=03160501&page=1&CONT_SEQ=375534&SEARCHKEY=TITLE&SEARCHVALUE=%EC%95%94%EC%83%9D%EC%A1%B4%EC%9E%90