Is childhood obesity linked to lymphoma?

Objectives Childhood obesity has been increasing rapidly in the last few decades. Recent epidemiologic studies are suggestive that obesity is linked with certain cancers. This study was designed to evaluate whether an association between childhood obesity and lymphoma exists.

Methods We conducted a retrospective review of 43 pediatric patients (17 females and 26 males, ages 2-17 years) imaged by PET-CT study at Loma Linda University Medical Center between August 1, 2013 and July 31, 2014. 13 patients underwent repeat scans during this time, resulting in 56 total exams performed on pediatric patients. Patients’ gluteal subcutaneous fat (in cm) was measured bilaterally by tabulating the largest thickness perpendicular from the skin surface to the iliac bone. The two sides were then averaged. In addition, patients’ height (cm) and weight (kg) were used to calculate body mass indices (BMI) for these patients. Standard BMI values were used (underweight if <18.5, normal weight if 18.5-24.9, overweight if 25-29.9, and obese if 30 or greater).

Results The patients with lymphoma (mean age 13.8) had both increased gluteal subcutaneous fat (mean 6.2) and BMI (mean 26.3) when compared to the other patients undergoing PET-CT examinations. Using only initial scans (prior to the initiation of therapy) also showed increased gluteal subcutaneous fat (mean 5.7). The other patients were younger in age (mean 9.1) and had lower gluteal subcutaneous fat (mean 3.5) and BMI (mean 18.7). These patients had the following diagnoses: paraneoplastic syndrome (1); mediastinal germinoma (1); hepatoblastoma (2); post-transplant lymphoproliferative disease (4); tonsillar cancer (1); neuroblastoma (2); leukemia (1); melanoma (1); osteosarcoma (2); adrenal gland cancer (1); rhabdomyosarcoma (1); and chondrosarcoma (1).

Conclusions The children with lymphoma fall into the overweight category by BMI and have increased gluteal subcutaneous fat thickness on PET-CT images. In comparison, the children with other malignancies are within the normal weight category by BMI. The results suggest that a link between childhood obesity and lymphoma does exist.