Objective:

To examine bodyweight, body mass index (BMI), and pain trajectories in children receiving chemotherapy for acute lymphoblastic leukemia (ALL), along with associated factors.

Approach:

• Study Design: A retrospective study involving 88 children and adolescents diagnosed with ALL and receiving chemotherapy.
• Data Collection: Clinical data were collected from medical records, including demographic information and measurements of bodyweight, height, and pain scores across five phases of treatment.
• Statistical Analysis: Group-based Trajectory Modeling was used to identify trajectory patterns for bodyweight, BMI, and pain.

Key Findings:

• Four latent classes for bodyweight trajectory were identified, with two-thirds of patients classified into the slightly low-normal bodyweight group, primarily consisting of 1–5-year-olds in the standard-risk ALL group.
• Older patients (6–15 years) were more likely to be in the high-bodyweight group [adjusted odds ratio (aOR) 184.6 (30.47-1118.48)].
• 94% of patients were classified as healthy weight for BMI, with overweight/obesity more common in older patients [aOR 5.99, (2.18–16.51)].
• Three-quarters of patients experienced high pain initially, with pain levels declining over time.
• High pain prevalence was noted in 6–15-year-olds [aOR 2.61 (1.07–6.36)], while mild pain was more common in younger patients (1–5 years) and those in the standard-risk group. Thai ethnicity was associated with mild pain [aOR 0.36 (0.13–0.99)].

Interpretation:

Older age at diagnosis correlates with higher bodyweight and higher BMI. High-risk ALL is linked to high bodyweight trajectory, and Thai ethnicity is associated with high BMI.

Limitations:

• The study is retrospective and may be subject to biases in data collection.
• The sample size may limit the generalizability of the findings.

Conclusion:

Older age at diagnosis and high-risk ALL status are associated with adverse growth and pain trajectories in pediatric ALL patients.