{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T23:20:31Z","timestamp":1790205631132,"version":"4.1.0"},"reference-count":30,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"15","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2007,5,20]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> To evaluate the effect of obesity (defined as a body mass index &gt; 95th percentile for age and sex at diagnosis) on outcome of pediatric acute lymphoblastic leukemia (ALL). <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> We retrospectively analyzed data from 4,260 patients with newly diagnosed ALL enrolled from 1988 to 1995 onto five concurrent Children's Cancer Group studies. Results were verified in a second cohort of 1,733 patients enrolled onto a sixth study from 1996 to 2002. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> The 1988 to 1995 cohort included 343 obese and 3,971 nonobese patients. The 5-year event-free survival rate and risk of relapse in obese versus nonobese patients were 72% \u00b1 2.4% v 77% \u00b1 0.6% (P = .02) and 26 \u00b1 2.4 v 20 \u00b1 0.6 (P = .02), respectively. After adjusting for other prognostic variables, obesity's hazard ratios (HRs) of events and relapses were 1.36 (95% CI, 1.04 to 1.77; P = .021) and 1.29 (95% CI, 1.02 to 1.56; P = .04), respectively. The effect of obesity was prominent in the 1,003 patients \u2265 10 years old at diagnosis; in this subset, obesity's adjusted HRs of events and relapses were 1.5 (95% CI, 1.1 to 2.1; P = .009) and 1.5 (95% CI, 1.2 to 2.1; P = .013), respectively. In a second cohort of 1,160 patients \u2265 10 years old, obesity's adjusted HRs of events and relapses were 1.42 (95% CI, 1.03 to 1.96; P = .032) and 1.65 (95% CI, 1.13 to 2.41; P = .009), respectively. The effect of obesity on outcome was unrelated to changes in chemotherapy doses, length of intervals between chemotherapy cycles, or incidence and severity of therapy-related toxicity. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Obesity at diagnosis independently predicts likelihood of relapse and cure in preteenagers and adolescents with ALL. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2006.07.7792","type":"journal-article","created":{"date-parts":[[2007,5,19]],"date-time":"2007-05-19T09:09:49Z","timestamp":1179565789000},"page":"2063-2069","source":"Crossref","is-referenced-by-count":201,"title":["Obesity and Outcome in Pediatric Acute Lymphoblastic Leukemia"],"prefix":"10.1200","volume":"25","author":[{"given":"Anna M.","family":"Butturini","sequence":"first","affiliation":[{"name":"From the Childrens Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles; Children's Oncology Group Statistical Center, Arcadia, CA; Children's Hospital of Philadelphia, Philadelphia, PA; Pharmacy Practice, University of Kansas Medical Center, Kansas City, KS; Children's National Medical Center, Washington, DC; Paediatric Oncology\/Haematology\/Bone Marrow Transplantation, British Columbia Children's Hospital and University of British Columbia, Vancouver, British..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick J.","family":"Dorey","sequence":"additional","affiliation":[{"name":"From the Childrens Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles; Children's Oncology Group Statistical Center, Arcadia, CA; Children's Hospital of Philadelphia, Philadelphia, PA; Pharmacy Practice, University of Kansas Medical Center, Kansas City, KS; Children's National Medical Center, Washington, DC; Paediatric Oncology\/Haematology\/Bone Marrow Transplantation, British Columbia Children's Hospital and University of British Columbia, Vancouver, British..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverly J.","family":"Lange","sequence":"additional","affiliation":[{"name":"From the Childrens Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles; Children's Oncology Group Statistical Center, Arcadia, CA; Children's Hospital of Philadelphia, Philadelphia, PA; Pharmacy Practice, University of Kansas Medical Center, Kansas City, KS; Children's National Medical Center, Washington, DC; Paediatric Oncology\/Haematology\/Bone Marrow Transplantation, British Columbia Children's Hospital and University of British Columbia, Vancouver, British..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Henry","sequence":"additional","affiliation":[{"name":"From the Childrens Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles; Children's Oncology Group Statistical Center, Arcadia, CA; Children's Hospital of Philadelphia, Philadelphia, PA; Pharmacy Practice, University of Kansas Medical Center, Kansas City, KS; Children's National Medical Center, Washington, DC; Paediatric Oncology\/Haematology\/Bone Marrow Transplantation, British Columbia Children's Hospital and University of British Columbia, Vancouver, British..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul S.","family":"Gaynon","sequence":"additional","affiliation":[{"name":"From the Childrens Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles; Children's Oncology Group Statistical Center, Arcadia, CA; Children's Hospital of Philadelphia, Philadelphia, PA; Pharmacy Practice, University of Kansas Medical Center, Kansas City, KS; Children's National Medical Center, Washington, DC; Paediatric Oncology\/Haematology\/Bone Marrow Transplantation, British Columbia Children's Hospital and University of British Columbia, Vancouver, British..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Fu","sequence":"additional","affiliation":[{"name":"From the Childrens Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles; Children's Oncology Group Statistical Center, Arcadia, CA; Children's Hospital of Philadelphia, Philadelphia, PA; Pharmacy Practice, University of Kansas Medical Center, Kansas City, KS; Children's National Medical Center, Washington, DC; Paediatric Oncology\/Haematology\/Bone Marrow Transplantation, British Columbia Children's Hospital and University of British Columbia, Vancouver, British..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Franklin","sequence":"additional","affiliation":[{"name":"From the Childrens Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles; 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Children's Oncology Group Statistical Center, Arcadia, CA; Children's Hospital of Philadelphia, Philadelphia, PA; Pharmacy Practice, University of Kansas Medical Center, Kansas City, KS; Children's National Medical Center, Washington, DC; Paediatric Oncology\/Haematology\/Bone Marrow Transplantation, British Columbia Children's Hospital and University of British Columbia, Vancouver, British..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul C.","family":"Rogers","sequence":"additional","affiliation":[{"name":"From the Childrens Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles; Children's Oncology Group Statistical Center, Arcadia, CA; Children's Hospital of Philadelphia, Philadelphia, PA; Pharmacy Practice, University of Kansas Medical Center, Kansas City, KS; Children's National Medical Center, Washington, DC; Paediatric Oncology\/Haematology\/Bone Marrow Transplantation, British Columbia Children's Hospital and University of British Columbia, Vancouver, British..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harland","family":"Sather","sequence":"additional","affiliation":[{"name":"From the Childrens Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles; 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