{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:50:43Z","timestamp":1791384643218,"version":"4.3.3"},"reference-count":32,"publisher":"Wiley","issue":"21","license":[{"start":{"date-parts":[[2018,10,25]],"date-time":"2018-10-25T00:00:00Z","timestamp":1540425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["CA21765"],"award-info":[{"award-number":["CA21765"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P50 GM115279"],"award-info":[{"award-number":["P50 GM115279"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012524","name":"American Lebanese Syrian Associated Charities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012524","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Children with acute lymphoblastic leukemia (ALL) have an increased risk of obesity and short stature. To the authors\u2019 knowledge, data regarding patients treated on contemporary protocols without cranial irradiation are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Changes in\n                      <jats:italic>z<\/jats:italic>\n                      scores for body mass index (BMI), height, and weight from the time of diagnosis to 5 years off therapy were evaluated using multivariable analysis in 372 children with ALL who were aged 2 to 18 years at the time of diagnosis and were enrolled on the St. Jude Children\u2019s Research Hospital Total XV protocol from 2000 through 2007.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The percentage of overweight\/obese patients increased from 25.5% at the time of diagnosis to approximately 50% during the off\u2010therapy period. Median BMI\n                      <jats:italic>z<\/jats:italic>\n                      scores increased significantly during glucocorticoid therapy (induction: \u22060.56; 95% confidence interval [95% CI], 0.29\u20100.64 [\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001]; and reinduction II: \u22060.22; 95% CI, 0.13\u20100.49 [\n                      <jats:italic>P<\/jats:italic>\n                      =.001]) and during the first year after therapy (\u22060.18; 95% CI, 0.08\u20100.46 [\n                      <jats:italic>P<\/jats:italic>\n                      =.006]). Among patients who were of healthy weight\/underweight at the time of diagnosis, those aged 2 to &lt;10 years at diagnosis had a significantly higher risk of becoming overweight\/obese during or after therapy compared with those aged \u226510 years (\n                      <jats:italic>P<\/jats:italic>\n                      =.001). Height\n                      <jats:italic>z<\/jats:italic>\n                      scores declined during treatment and improved after therapy. Being aged 2 to &lt;10 years at the time of diagnosis, being of low\u2010risk status, having a white blood cell count\u2009&lt;\u200950\u00d710\n                      <jats:sup>9<\/jats:sup>\n                      \/L at the time of diagnosis, and having negative central nervous system disease were associated with significantly better improvements in\n                      <jats:italic>z<\/jats:italic>\n                      scores for height during the off\u2010therapy period compared with being aged \u226510 years, being of standard\u2010risk\/high\u2010risk status, having a white blood cell count \u2009\u2265\u200950\u00d710\n                      <jats:sup>9<\/jats:sup>\n                      \/L, and having positive central nervous system disease, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results of the current study demonstrate that obesity is prevalent, and height growth, especially in patients with identified risk factors, appears compromised. Multidisciplinary intervention should begin during induction therapy and continue during the off\u2010therapy period.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.31736","type":"journal-article","created":{"date-parts":[[2018,10,25]],"date-time":"2018-10-25T13:09:21Z","timestamp":1540472961000},"page":"4248-4259","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Changes in body mass index, height, and weight in children during and after therapy for acute lymphoblastic leukemia"],"prefix":"10.1002","volume":"124","author":[{"given":"Emily K.","family":"Browne","sequence":"first","affiliation":[{"name":"Department of Pediatric Medicine St. Jude Children\u2019s Research Hospital  Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinmei","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Biostatistics St. Jude Children\u2019s Research 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