儿童急性淋巴细胞白血病（ALL）治疗的进展显著提高了存活率，治疗后期效应成为一个日益关注的问题。ALL治疗后肥胖的发展频繁发生，并可能显著增加长期发病率和死亡率。我们对208例ALL儿童从诊断到完成治疗的体重轨迹进行了研究。我们发现，7.2%的孩子在诊断时超重或肥胖，到诱导治疗结束时增长到19.7%，治疗完成后增至20.8%。在多因素线性回归模型中，ALL诊断时的年龄、化疗方案类型和诊断时的BMI z评分是诱导治疗后BMI z评分的显著预测因子，而诊断时的BMI z评分是治疗完成后BMI z评分的唯一显著预测因子。在120例儿童的亚组中，我们发现诊断时的营养状况与ALL复发风险或整体生存率无关。我们的发现表明，在ALL治疗早期出现体重增加，并且这是由诊断时的体重状况预测的。因此，在整个治疗过程中应该评估营养状况，并且应早期考虑体重管理干预，尤其是对于诊断时体重较高的患者。© 2023. Springer Nature Limited.

The advances in pediatric acute lymphoblastic leukemia (ALL) care have substantially increased survival, and the late effects of treatment are a growing concern. Obesity development is frequent following ALL therapy and may significantly contribute to long-term morbidity and mortality. We examined the body mass trajectory of 208 children with ALL, from the diagnosis to the completion of therapy. We found that 7.2% of children were overweight or obese at diagnosis, which increased to 19.7% at the end of induction therapy and 20.8% after completion of treatment. In a multivariable linear regression model, age at ALL diagnosis, the type of chemotherapy regimen, and body mass index (BMI) z-score at diagnosis were significant predictors of BMI z-score after induction therapy, whereas BMI z-score at diagnosis was the only significant predictor of BMI z-score at the completion of treatment. In a subgroup of 120 children, we found no association between nutrition status at diagnosis and the risk of ALL relapse or poorer overall survival. Our findings indicate that weight gain occurs early during ALL therapy and is predicted by weight status at diagnosis. Therefore, nutritional status should be assessed throughout treatment, and weight management interventions should be considered early, particularly for patients with higher weight at diagnosis.© 2023. Springer Nature Limited.