Early Increase in Weight Is Seen During Treatment for Paediatric Acute Lymphoblastic Leukaemia-A Retrospective Analysis of Medical Records.

Abstract

Aim: The aim of the study was to assess growth patterns in a national cohort of children aged 0-17.9 years diagnosed with acute lymphoblastic leukaemia (ALL).

Methods: Medical records at the four tertiary paediatric oncology hospitals in Norway were used for retrospective data collection. Anthropometrics were collected for patients diagnosed between 1 January 2008 and 31 December 2018, weekly, or as soon after as available, and followed up for 10 years after diagnosis. Z-scores were collected from the growth curve function in the medical record software and compared to the Norwegian reference population. Generalised additive mixed model was used for analysis.

Results: The analysis included 375 paediatric ALL patients. Data displayed an initial weight loss (z-score from 0.00 to -0.25) and a stagnation in height growth (z-score from 0.20 to -0.55). Throughout treatment and into remission, weight and body mass index stabilised significantly above the average healthy population (z-score: 0.30 and 0.55 respectively). Height was nonsignificantly different in remission compared to the general population (z-score: -0.15).

Conclusion: Weight gain, and BMI increase, occurred earlier than previously reported. Height was negatively affected by treatment. Monitoring of nutritional status, nutritional support efforts and physical activity is important throughout treatment to prevent unwanted and avoidable fluctuations in growth.