To our knowledge, this is the first consortium study to characterize the
impact of weight during therapy, in contrast to weight at diagnosis, on
EFS and TRT. By using analyses designed to reflect the clinical experience of variations in weight to evaluate EFS (ie, as cumulative exposure) and TRT (ie, in proximity to event), we present here a more
accurate and complete depiction of the influence of weight than has
previously been reported. With this approach, we found that only
those children with sustained underweight or obese status during
intensive phases of treatment for high-risk ALL were at significantly
greater risk for relapse or death and development of TRT. For patients
who remained either obese or underweight for half of premaintenance therapy, the risk for eventual relapse or death was up to double