• Megan R Winkler, Marilyn J Hockenberry, Kathy S McCarthy, and Susan G Silva.
• Duke University in Durham, NC.
• Oncol Nurs Forum. 2015 Jul 1; 42 (4): E287-93.

Purpose/ObjectivesTo 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.DesignLongitudinal, descriptive.SettingHematology/oncology clinic in the southwestern United States.Sample62 child and adolescent ALL survivors receiving treatment and follow-up care from 1999-2013.MethodsRetrospective chart review of height, weight, and body mass index.Main Research VariablesAnnual obesity/overweight rates and developmental age groups.FindingsDifferent 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.ConclusionsImportant 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 NursingObesity/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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