Prognostic significance of being overweight and obese at diagnosis in children with acute lymphoblastic leukemia

<b>Background:</b> Underweight, overweight, and obesity at diagnosis may all worsen prognosis in childhood acute lymphoblastic leukaemia (ALL) but no studies have estimated prevalence of unhealthy weight status at diagnosis in large representative samples using contemporary definitions of weight status based on BMI for age.<p></p> <b>Methods:</b> Retrospective study which aimed to estimate prevalence of underweight, overweight, and obesity at diagnosis for patients with childhood ALL on three successive UK treatment trials: UKALL X (1985-1990, n 1033), UKALL XI (1990-1997, n 2031), UKALL 97/ 99 (1997-2002, n 898) .The BMI for age was used to define weight status with both UK 1990 BMI for age reference data and the Cole-International Obesity Task Force (IOTF) definitions. Results: Prevalence of underweight was 6% in the most recent trial for which data were available. Prevalence of overweight and obesity was 35% in the most recent trial when expressed using Cole-IOTF definitions; 41% when expressed relative to UK 1990 reference data.<p></p> <b>Conclusions:</b> Even with highly conservative estimates >40% of all UK patients with ALL were underweight, overweight, or obese at diagnosis in the most recent trial for which UK data are available (UKALL 97/99, 1997-2002).<p></p&gt