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A bilingual dietary intervention early in treatment is feasible and prevents weight gain in childhood acute lymphoblastic leukemia (ALL)
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  • Michelle Walters,
  • Catriona Mowbray,
  • Tracey Jubelirer,
  • Shana Jacobs,
  • Kara Kelly,
  • Karen Smith,
  • Yujing Yao,
  • Jin Zhezhen,
  • Elena Ladas
Michelle Walters
Columbia University Medical Center
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Catriona Mowbray
Children's National Medical Center
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Tracey Jubelirer
The Children's Hospital of Philadelphia
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Shana Jacobs
Children's National Health System
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Kara Kelly
Roswell Park Cancer Institute
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Karen Smith
The Children's Hospital of Philadelphia
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Yujing Yao
Columbia University
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Jin Zhezhen
Columbia University Mailman School of Public Health
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Elena Ladas
Columbia University
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Abstract

Background: Childhood acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy. The onset of obesity during childhood ALL has been well established and is associated with inferior survival rates and increased treatment-related toxicities. This pilot study sought to determine if a dietary intervention is feasible and minimizes weight gain during the initial phases of treatment for ALL. Methods: Participants were recruited from four institutions, fluent in English or Spanish, between 5-21 years old, and enrolled within three days of starting induction therapy. Participants were counseled for six months to follow a low glycemic diet. Dietary and anthropometric data were collected at baseline, end of induction, and end of month six (NCT03157323). Results: Twenty-three of 28 participants (82.1%) were evaluable and included in the analysis. Dietary intake of several nutrients targeted by the nutrition intervention declined (sugar, P = 0.003 and glycemic load, P = 0.053). We also observed a persistent increase in total vegetables across each timepoint (P = 0.015) and by the end of the intervention (P = 0.033). Importantly, we did not observe an increase in body mass index z-score during induction or over the six-month intervention period. Most families found the nutrition intervention easy to follow (60%) and affordable (95%) despite simultaneous initiation of treatment for ALL. Conclusions: A six-month nutrition intervention initiated during the initial phase of treatment for childhood ALL is feasible and may prevent weight gain. Our preliminary findings need to be confirmed in a larger clinical trial.

Peer review status:Published

14 Oct 2020Submitted to Pediatric Blood & Cancer
14 Oct 2020Submission Checks Completed
14 Oct 2020Assigned to Editor
15 Oct 2020Reviewer(s) Assigned
04 Nov 2020Review(s) Completed, Editorial Evaluation Pending
04 Nov 2020Editorial Decision: Revise Major
09 Dec 2020Assigned to Editor
09 Dec 2020Submission Checks Completed
09 Dec 20201st Revision Received
10 Dec 2020Reviewer(s) Assigned
28 Dec 2020Review(s) Completed, Editorial Evaluation Pending
29 Dec 2020Editorial Decision: Revise Minor
04 Jan 2021Assigned to Editor
04 Jan 2021Submission Checks Completed
04 Jan 20212nd Revision Received
05 Jan 2021Review(s) Completed, Editorial Evaluation Pending
05 Jan 2021Editorial Decision: Accept
May 2021Published in Pediatric Blood & Cancer volume 68 issue 5. 10.1002/pbc.28910