P1014 - SYSTEMATIC REVIEW OF CHANGES IN BODY COMPOSITION OF CHILDREN AND YOUNG PEOPLE UNDERGOING TREATMENT FOR ACUTE LYMPHOBLASTIC LEUKEMIA ALL

P1014

SYSTEMATIC REVIEW OF CHANGES IN BODY COMPOSITION OF CHILDREN AND YOUNG PEOPLE UNDERGOING TREATMENT FOR ACUTE LYMPHOBLASTIC LEUKEMIA ALL

L. Zahed^1,*, G. O'Connor¹, R. Revuelta Iniesta ²

¹GOS ICH, UCL, London, ²Public Health and Sport Science, University of Exeter , Exeter , United Kingdom

Rationale: Emerging evidence suggests an increased risk of obesity and sarcopenic obesity in childhood ALL survivors, often beginning early in treatment. However, no systematic review has assessed body composition changes during treatment. This review evaluates studies using BIA and/or DEXA to assess body composition in children with ALL during and after therapy.

Methods: This study followed PRISMA guidelines and was registered in PROSPERO (CRD42023480732). PubMed, MEDLINE (OVID), and CINHAL were searched up to March 2024. Primary outcomes were changes in fat mass (FM), fat-free mass (FFM), and fat % via BIA and DEXA; secondary outcome was BMI changes. Included studies involved ALL patients aged 0–21 years during or post-treatment (excluding >10 years post-treatment). Risk of bias was assessed using the Joanna Briggs Institute tool.

Results: Of 126 studies, 12 were included (7 cross-sectional, 5 prospective). DEXA was used in 7 studies, BIA in 3, and one utilised both. Most studies reported increased fat % (1.08% to 42.8%) and FM (11.9 kg to 42.8 kg) after treatment. FFM findings were mixed, with some studies indicating stability (42.8 ± 4.0 kg) and others showing non-significant fluctuations across treatment phases (3.7 ± 14.4 kg to 36.4 ± 1.6 kg). BMI was generally elevated in ALL survivors versus controls. Considerable heterogeneity in methodology (e.g., DEXA/BIA protocols and calibration) and outcome reporting (reference and population variation) was observed.

Conclusion: Despite methodological limitations, this review reveals a persistent increase in FM and reduction in FFM in childhood ALL patients, including post-treatment. Large, standardised, international studies are needed to define clinically meaningful outcomes.

Disclosure of Interest: None declared