Obesity in patients with acute lymphoblastic leukemia in childhood

As a result of treatment, almost 4/5 of subjects with a diagnosis of cancer in childhood become long-term survivors. It has been estimated that in the United States about 1 every 640 adults between the ages of 20 and 39 years is a survivor of pediatric cancer [1]. Nevertheless, three decades after a diagnosis of cancer, almost 75% of survivors have a chronic health condition [2]. Consequently, the late side-effects of the cancer treatment have obtained an increased attention and the long-term monitoring of survivors has become an important part of their overall health care.Obesity is a worldwide health chronic condition, affecting also cancer survivors, and is one of the most important factors increasing cardiovascular morbidity and mortality.Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy, affecting approximately 1- 4.75 per 100.000 people worldwide, with a peak age of occurrence between 2 and 6 years of age. It accounts for 80% of all leukemia cases in children [3]. Italy, United States, Switzerland and Costa Rica are the countries with the highest incidence of ALL [4]. From 1975 through 2006, ALL incidence rates increased significantly, with an annual percentage change of 0.8% [5]. Especially in children aged 1-4 years, the annual percent change reaches the 1.2% [4]. Nevertheless, recent progress in risk-adapted treatment for childhood ALL has secured 5-year event-free survival rates of approximately 80% and 8-year survival rates approaching 90% [1]. Survivors of ALL form the largest group of long-term survivors from childhood cancer, even if they have to be considered a heterogeneous group depending on the treatment. The standard treatment of childhood ALL includes different phases (induction, consolidation/intensification, and maintenance phases) in which combination chemotherapy, central nervous system (CNS) sanctuary therapy with intrathecal chemotherapy and high dose chemotherapy are given. CNS treatment has been an essential compo