Assessment of growth and pain trajectories for children and adolescents receiving chemotherapy for acute lymphoblastic leukemia in Northern Thailand using group-based trajectory modeling.
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BACKGROUND: Children with leukemia often experience growth and symptom changes during treatment. Our aim was to examine bodyweight, body mass index (BMI) and pain trajectories, along with associated factors. METHODS: A retrospective study was conducted among 88 children and adolescents receiving chemotherapy for acute lymphoblastic leukemia (ALL). Group-based Trajectory Modeling was applied to identify trajectory patterns. RESULTS: Four latent classes for bodyweight trajectory were identified, two-thirds of patients classified into slightly low-normal bodyweight group and mostly were 1-5 years old and in the standard-risk ALL group. Patients in the high-bodyweight group were more likely to be 6-15 years old [adjusted odds ratio (aOR) 184.6 (30.47-1118.48)] and in the high-risk ALL group [aOR 5.36 (1.38-20.8)]. Three latent classes for BMI and pain trajectories were identified. For BMI changes, 94% of patients classified as healthy weight. A minority of patients classified as overweight/obese, which was mainly observed among 6-15-year-old patients [aOR 5.99, (2.18-16.51)] of Thai ethnicity [aOR 4.58 (1.33-15.77)]. Three-quarters of patients experienced high pain initially, and pain levels generally declined over time. High pain was more prevalent in 6-15-year-old patients [aOR 2.61 (1.07-6.36)], whereas mild pain was more common in 1-5-year-old patients and in the standard-risk ALL group. Thai ethnicity was associated with mild pain [aOR 0.36 (0.13-0.99)]. CONCLUSIONS: Older age at diagnosis was significantly associated with higher bodyweight, higher BMI and high pain trajectory. The high-risk ALL group was associated with high bodyweight trajectory, and Thai ethnicity was associated with high BMI and mild pain trajectory.