INFLUENCE OF TREATMENT MODALITIES ON BODY-WEIGHT IN ACUTE LYMPHOBLASTIC-LEUKEMIA

Weight for height of 92 patients (51 girls and 41 boys) treated for ac ute lymphoblastic leukemia (ALL) was evaluated in a longitudinal study . Fifty-four patients received cranial irradiation (CI) with a dose of 18 dr 24 Gy and 38 patients did not receive CI. Seventy-seven patient s were treated according to a normal-risk protocol and 15 patients rec eived more intensive chemotherapy according to a high-risk protocol. I n most of the patients the duration of follow-up was 12 years for irra diated patients and 4.5 years for the nonirradiated patients. Thirty o f 92 patients were treated according to a protocol without CI, but wit h a difference in the use of corticosteroids: 19 patients received dex amethasone during the remission-induction and maintenance treatment an d 11 patients received prednisone. The influence of dexamethsone vs. p rednisone, sex, CI and high-dose vs. low-dose chemotherapy on weight f or height was evaluated. Patients who received dexamethasone showed a significant increase in weight for height immediately after the start of therapy. In patients who received CI, weight for height significant ly increased after the first year of treatment. The overweight in thes e patients persisted during the whole follow-up period. The weight for height of patients treated with prednisone and of patients who did no t receive CI was below the mean of the normal population during treatm ent but was not different from normal after cessation of therapy. No d ifference in weight gain was seen between boys and girls and between p atients who were treated with high vs. normal-risk protocols. (C) 1996 Wiley-Liss, Inc.