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Childhood and AYA acute lymphoblastic leukemia (ALL) incidence and obesity prevalence have shown concurrent increases. We sought to identify whether obesity may be a risk factor for childhood and AYA ALL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Characteristics from individuals with ALL, aged 2\u201030\u00a0years, diagnosed 2004\u20102017 and treated on Children's Oncology Group (COG) protocols with available pre\u2010treatment anthropometric data (N\u00a0=\u00a04726) were compared to National Health and Nutrition Examination Survey controls (COG AALL17D2). Body mass index (BMI) was defined using standard CDC definitions. Multivariate conditional logistic regression assessed associations between BMI and ALL with additional analyses stratified by sex and race\/ethnicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among cases (72% high\u2010risk (HR) B\u2010ALL, 28% T\u2010ALL), 5% had underweight, 58% normal weight, 17% overweight, and 20% obesity. Underweight (OR 2.11, 95% CI 1.56\u20102.85) and obesity (OR 1.32, 95% CI 1.15\u20101.53) were associated with B\u2010ALL diagnosis. Specifically, obesity was associated with B\u2010ALL among males (OR 1.57, 95% CI 1.30\u20101.91) and Hispanic children (OR 1.78, 95% CI 1.39\u20102.29). Obesity was also associated with central nervous system (CNS) involvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pre\u2010treatment obesity is associated with HR B\u2010ALL among males and Hispanics, as well as with CNS involvement, suggesting common physiology between obesity and leukemogenesis. An association between underweight and ALL was confirmed, likely due to cancer\u2010associated wasting. These results have important public health implications for obesity prevention and treatment in children and adolescents to reduce cancer risk.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.3334","type":"journal-article","created":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T09:48:20Z","timestamp":1595584100000},"page":"6825-6835","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Body mass index associated with childhood and adolescent high\u2010risk B\u2010cell acute lymphoblastic leukemia risk: A Children\u2019s Oncology Group report"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3420-3167","authenticated-orcid":false,"given":"Taumoha","family":"Ghosh","sequence":"first","affiliation":[{"name":"Division of Epidemiology and Clinical Research Department of Pediatrics University of Minnesota Minneapolis MN USA"},{"name":"Division of Hematology\/Oncology Department of Pediatrics University of Minnesota Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Richardson","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Clinical Research Department of Pediatrics University of Minnesota Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M.","family":"Gordon","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology Department of Pediatrics University of Minnesota Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin R.","family":"Ryder","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Clinical Research Department of Pediatrics University of Minnesota Minneapolis MN USA"},{"name":"Center for Pediatric Obesity Medicine University of Minnesota Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Logan G.","family":"Spector","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Clinical Research Department of Pediatrics University of Minnesota Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie M.","family":"Turcotte","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology Department of Pediatrics University of Minnesota Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,24]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"SEER cancer statistics review, 1975\u20132017","author":"Howlader NNA","year":"2020"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(16)00002-8"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-018-0402-z"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyu265"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmg.2015.10.003"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2014.21"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6601509"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsr1606602"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.32109"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2012.742523"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.15904"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2009-0285"},{"key":"e_1_2_10_14_1","volume-title":"United States Cancer Statistics: 1999\u20132014 incidence and mortality web\u2010based report","author":"United States Cancer Statistics Working Group","year":"2017"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.22137"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-08-595389"},{"key":"e_1_2_10_17_1","unstructured":"National Health and Nutrition Examination Survey Data.Hyattsville MD:Department of Health and Human Services.https:\/\/wwwn.cdc.gov\/nchs\/nhanes\/. 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