Body composition after bone marrow transplantation in childhood

Purpose/Objectives: To describe the body composition and fat distribution of childhood bone marrow transplantation (BMT) survivors at least one year post-transplantation and examine the ability of the Centers for Disease Control and Prevention criteria to identify survivors with elevated body fat percentage. Design: Cross-sectional, descriptive. Setting: Pediatric oncology program at a National Cancer Institute-designated comprehensive cancer center. Sample: 48 childhood BMT survivors (27 males and 21 females). Methods: Measurements included dual-energy x-ray absorptiometry scan, height, weight, and physical activity. Descriptive statistics were reported and mixed-model linear regression models were used to describe findings and associations. Main Research Variables: Total body fat percentage and central obesity (defined as a ratio of central to peripheral fat of 1 or greater). Findings: Fifty-four percent of survivors had body fat percentages that exceeded recommendations for healthy body composition and 31% qualified as having central obesity. Previous treatment with total body irradiation was associated with higher body fat percentage and central obesity, and graft-versus-host disease was associated with lower body fat percentage. The body mass index (BMI) criteria did not correctly identify the BMT survivors who had elevated body fat percentage. Conclusions: Survivors of childhood BMT are at risk for obesity and central obesity that is not readily identified with standard BMI criteria. Implications for Nursing: Nurses caring for BMT survivors should include evaluation of general and central obesity in their assessments. Patient education materials and resources for healthy weight and muscle building should be made available to survivors. Research is needed to develop appropriate interventions.