Nutritional status and physical activity of childhood leukemia survivors

Main Article Content

Conny Tanjung
Johannes Bondan Lukito
Prima Dyarti Meylani


Background Acute lymphoblastic leukemia (ALL), the most
common malignancy of childhood, has an overall cure rate of
approximately 80%. Long-term survivors of childhood ALL are
at increased risk for obesity and physical inactivity that may lead
to the development of diabetes, dyslipidemia, metabolic syndrome,
as well as cardiovascular dis eases, and related mortality in the
years following treatment.
Objective To evaluate the physical activity and the propensity
for developing obesity longer term in ALL survivors.
Methods This retrospective cohort study included all ALL
survivors from Pantai Indah Kapuk (PIK) Hospital. We assessed
their physical activity and nutritional status at the first time of
ALL diagnosis an d at the time of interview.
Results Subjects were 15 ALL survivors aged 7 to 24 years. The
median fo llow up time was 6.4 years (range 3 to 10 years). Only
2 out of 15 survivors were overweight and n one were obese.
All survivors led a sedentary lifestyle. Most female subjects
had increased BMI, though most were not overweight/obese.
Steroid therapy in the induction phase did not increase the risk
of developing obesity in ALL survivors.
Conclusion Lon g-term survivors of childh ood ALL do not meet
physical activity recommendations according to the CDC (Centers
for Disease Control). Howevei; steroid therapy do not seem to
lead to overweight/obesity in ALL survivors.

Article Details

How to Cite
Tanjung C, Lukito J, Meylani P. Nutritional status and physical activity of childhood leukemia survivors. PI [Internet]. 30Apr.2014 [cited 25Feb.2020];54(2):67-2. Available from:
Received 2016-08-17
Accepted 2016-08-17
Published 2014-04-30


1. Razzouk BI, Rose SR, Hongeng S, Wallace D, Smeltzer MP, Zacher M, et al. Obesity in survivors of childh ood acute lymphoblastic leukemia and lymphoma. J Clin Oncol. 2007; 25: 1183-9.
2. Oeffinger KC, Adams-Huet B, Victor RG, Church TS, Snell PG, Dunn AL, et al. Insulin resistance and risk factors for cardiovascular disease in young adult survivors of childhood acute lymphoblas tic leukemia. J Clin Oncol. 2009;27 :3698- 704.
3. Murphy AJ, Wells JC, Williams JE, Fewtrell MS, Davies PS, Webb DK. Body composition in children in remission from acute lymphoblastic leukemia. Am J Clin Nutt. 2006;83: 70- 74.
4. Florin TA, Fryer GE, Miyoshi T, Weitzman M, Mertens AC, Hudson MM, et al. Physical inactivity in adult survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study. Cancer Epidemiol Biomarkers Prev. 2007;16:1356-63.
5. Sjarif DR, Nasar SS, Devaera Y, Tanjung C. Rekomendasi Ikatan Dokter Anak Indonesia. Asuhan Nutrisi Pediatrik. BP IDAI, Jakarta; 2011.
6. Mody R, Li S, Dover DC, Sallan S, Leisenring W, Oeffunger KC, etal. Twenty-five-year follow-up among survivors ofchildhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study. Blood. 2008;111:5515-23.
7. Jarfelt M, Lannering B, Bosaeus I,JohannssonG, BjamasonR. Body composition in young adult survivors of childhood acute lymphoblastic leukaemia. Eur J Endocrinol. 2005:153:81-9.
8. Janiszewski PM, Oeffinger KC, Church TS, Dunn AL, Eshelman DA, Victor RG, et al. Abdominal obesity, liver fat, and muscle composition in survivors of childhood acute lymphoblastic leukemia. J Clin Endocrinol Metab. 2007;92:3816-21.
9. Rogers PC, Meacham LR, Oeffinger KC, Henry DW, Lange BJ. Obesity in pediatric oncology. Pediatr Blood Cancer. 2005;45:881-91.
10. Nysom K, Holm K, Michaelsen KF, Hertz H, Muller J, Molgaard C. Degree of fatness after treatment for acute lymphoblastic leukemia in childhood. J Clin Endocrinol Metab. 1999;84:4591-6.
11. Neville KA, Cohn RJ, Steinbeck KS, Johnston K, Walker JL. Hyperinsulinemia, impaired glucose tolerance, and diabetes mellitus in survivors of childhood cancer: prevalence and risk factors. J Clin Endocrinol Metab. 2006;91:4401-7.
12. Warner JT, Evan s WD, Webb DK, Gregory JW. Body composition of long-term survivors of acute lymphoblastic leukemia. Med Pediatr Oncol. 2002;38: 165-72.
13. Odame I, Reilly JJ, Gibson BE, Donaldson MD. Patterns of obesity in boys and girls after treatment for acute lymphoblastic leukaemia. Arch Dis Child. 1994;71:147-9.
14. Ahmed SF, Tucker P, Mushtaq T, Wallace AM, Williams DM, Hughes IA. Short-term effects on linear growth and bone turnover in children randomized to receive prednisolone or dexamethasone. Clin Endocrinol (Oxf). 2002;57:185-91.
15. Wallace AM, Tucker P, Williams DM, Hughes IA, Ahmed SF. Short-term effects of prednisolone and dexamethasone on circulating concentrations ofleptin and sex hormone-binding globulin in children being treated for acute lymphoblastic leukaemia. Clin Endocrinol (Oxf) 2003;58:770-6.
16. van Brussel M, Takken T, Lucia A, van der Net J, Helders PJ. Is physical fitness decreased in survivors of childhood leukemia? A systematic review. Leukemia. 2005;19:13-7.
17. World Cancer Research Fund/American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. AICR; Washington, DC: 2007.
18. Centers for Disease Control and Prevention. Physical activity for everyone. [cited June 8 20 12]. Available from:
19. U.S. Department of Health & Human Services. Active children and adolescents. Phys ical activity guidelines for Americans. [cited June 8 2012]. Available from: