Body Mass Index and Risk of Leukemia in Older Women

Abstract

Overweight [body mass index (BMI) 25.0-29.9 kg/m2] and obesity (BMI ≥30 kg/m2) are risk factors for several malignancies. The Iowa Women's Health Study was examined to determine whether increased BMI was associated with leukemia development. Over 40,000 Iowa women (ages 55-69 years) completed a self-administered lifestyle and health questionnaire in 1986 that included current height and weight. Two hundred women developed leukemia during the period 1986 to 2001 including 74 acute myelogenous leukemia (AML) and 88 chronic lymphocytic leukemia. The risk of AML was increased among women who reported being overweight or obese (relative risk, 1.9; 95% confidence interval, 1.0-3.4; relative risk, 2.4; 95% confidence interval, 1.3-4.5; Ptrend = 0.006) compared with women of normal weight. There was little evidence of a positive association for chronic lymphocytic leukemia (Ptrend = 0.6). Given the prevalence of overweight and obesity in the United States, the population attributable risk of AML due to obesity could approach 30%.

Complex karyotype including ring chromosome 11 in a patient with acute myeloid leukemia: case report

“…Epidemiological, case control and meta-analysis studies have correlated obesity with poor prognosis for AML. 31 , 32 , 33 , 34 In addition, Finn et al reported an association between obesity and cytogenetic categories. 35 Several studies have considered that obesity might confer poor prognosis in different ways.…”

“… 35 Several studies have considered that obesity might confer poor prognosis in different ways. 3 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 For example, the mean elimination half-life of doxorubicin is longer in obese patients than in normal patients, thus increasing its toxicity to these patients. Adipocytes are also mesenchyme-derived cells and were previously considered to play only a passive “space filling” role in the bone marrow cavity.…”

“… 29 Other proposed mechanisms for the negative association of obesity with AML include impaired immune function due to chronic elevation of tumor necrosis factor alpha (TNFα), decreased T lymphocyte production, increased leptin and increased insulin-like growth factor activity, which are involved in hematopoiesis and survival of myeloid cells. 33 , 34 , 35 , 37 , 38 …”

Obesity in adult acute myeloid leukemia is not associated with inferior response or survival even when dose capping anthracyclines: An ECOG‐ACRIN analysis

“…Obesity has been identified as a significant risk factor for acute myeloid leukemia (AML) development, and case-control studies have demonstrated an approximate 1.5-fold to 2.0-fold increase in adult AML risk associated with obesity, [1][2][3][4][5] particularly in women. [6][7][8] The degree of obesity, its development over the course of life, and, more recently, obesity in adolescents are each associated with an increasing risk of adult AML. 2,9,10 The observation of an increasing incidence of leukemia by birth cohort and by generation supports the hypothesis that adult leukemia risks are appreciably modulated by environmental and lifestyle exposures, 11 thus the obesity-associated lifestyle represents an important and potentially modifiable factor (or behavior) associated with leukemia risk.…”

“…Obesity has been identified as a significant risk factor for acute myeloid leukemia (AML) development, and case–control studies have demonstrated an approximate 1.5‐fold to 2.0‐fold increase in adult AML risk associated with obesity, 1–5 particularly in women 6–8 . The degree of obesity, its development over the course of life, and, more recently, obesity in adolescents are each associated with an increasing risk of adult AML 2,9,10 .…”