Children with acute lymphoblastic leukaemia (ALL) who are overweight or obese for longer periods during treatment face significantly worse outcomes, according to a new study.
Researchers followed 794 children treated for ALL on a Dana-Farber Cancer Institute protocol between 2005 and 2011, assessing their body mass index (BMI) from diagnosis through to the end of treatment. The study found that children who were overweight or obese at two or more time points had notably lower overall survival (OS) and event-free survival (EFS), and a higher rate of relapse compared to those with excess weight at one or fewer time points.
At diagnosis, nearly 30% of patients were overweight or obese, rising to 48.4% by the end of treatment. Although having excess weight early in treatment was not linked to immediate treatment toxicity or higher levels of minimal residual disease, prolonged exposure was strongly associated with inferior outcomes. Specifically, three-year OS was 93.8% for children with repeated overweight or obesity, compared to 98.0% in those with less exposure. Relapse rates were also nearly double.
The findings suggest that it’s not simply the presence of obesity at diagnosis that matters, but the sustained duration of excess weight throughout treatment. The researchers highlight the need for interventions aimed at preventing and managing obesity during childhood cancer treatment to help improve survival rates and long-term outcomes in children with ALL.
Reference
Ladas E et al. Overweight or obesity and outcomes in children with acute lymphoblastic leukemia. JAMA Netw Open. 2025;8(5):e259952.
