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Jennifer H Aldrink, Catherine Paris, Wei Wang, Erin Teeple, Aaron Wilcox, Kasi Eastep, Sarah H O’Brien and Marc P Michalsky
Background: Evidence exists in the adult literature linking obesity to an elevated risk for the development of certain malignancies, and to an increase in treatment-related complications. Little information is available examining this relationship in the obese pediatric oncology population. Methods: We performed a retrospective analysis for all patients with a malignancy and treated at our institution between January, 2005 and December, 2009. Body mass index (BMI) was calculated, categorizing them as obese or nonobese based upon their BMI percentile. Stratification by tumor type (leukemia/lymphoma, solid tumor) was performed. Data on the incidence of fifteen potential complications were recorded. Results: Sixty-three patients (17%) were classified as obese, and 302 (83%) as nonobese. Wound complications occurred more frequently in obese patients with leukemia/lymphoma compared to nonobese patients (13.2% vs. 1.6%, p=0.0075). Renal toxicity occurred more frequently in the obese patients than in the nonobese patients (38.1% vs. 26.2% (p=0.06). Conclusions: In a growing population of obese pediatric patients, certain malignancy-related treatment complications may occur at an increased incidence, including higher rates of renal toxicity and wound complications. This report highlights early treatment-related complications by BMI in pediatric patients with cancer, and demonstrates the need for an individualized approach in treating this population.