We therefore hypothesized that the impact of weight on
EFS is not determined exclusively at diagnosis but rather results from
continued exposure to an extreme weight during the subsequent critical
period of intensified therapy before maintenance.15 We hypothesized
a similar effect on the incidence and patterns of acute TRT, which
would not be determined by weight at diagnosis but rather by weight
surrounding the period of acute toxicity. The purpose of this study was
to evaluate the effect of weight variations during treatment on EFS and
development of TRT in a large cohort of children treated in a
cooperative-group setting for high-risk ALL.