A 24-month phone and app/web-based diet and physical activity intervention that was successful for weight loss in the general population did not result in greater weight loss or improvement in cardiovascular (CV) risk factors among adult survivors of childhood acute lymphoblastic leukemia (ALL). Reduced adherence to the intervention beyond 12 months, or lack of ALL survivor-specific tailoring, may account for these findings.

Obese and overweight 5-year ALL survivors diagnosed after 21 years of age from Childhood Cancer Survivor Study (CCSS) were randomized to a 24-month remotely delivered diet/physical activity intervention or self-directed weight loss (control) and stratified by cranial radiotherapy (CRT). The intervention emphasized a low-calorie DASH diet and physical activity via an app, a website, and weekly coach calls.

Of 358 survivors, 181 were randomized to the intervention and 177 to control. Baseline mean weight was 98.6 kg for intervention and 94.9 kg for controls. Fifty-five intervention participants were adherent beyond 1 year. At 12 months, after controlling for CRT, sex, race/ethnicity, and age, the adjusted mean change in weight from baseline was -1.83kg for intervention and -0.16kg for control participants. At 24 months, the adjusted mean change in weight was -0.36kg for intervention and +0.18kg for control participants with the average difference of -0.54 kg between the arms. A small proportion had at least 5% weight loss at 24 months. No significant differences in CV risk factors were observed.