High body mass index did not result in poor outcome in Taiwanese children with acute myeloid leukemia: a single-institution experience

Abstract

Overweight/obese patients with acute myeloid leukemia (AML) are reported as experiencing inferior outcomes and greater numbers of treatment-related complications. We retrospectively studied 58 children with newly diagnosed AML who received chemotherapy at Chang Gung Memorial Hospital between January 2003 and December 2011. Patients enrolled were considered overweight if body mass index (BMI) was ≥85th percentile. Fifteen of 58 (25.9 %) patients were judged overweight by this criterion. Patients diagnosed in the last third of this period (2009-2011) had a higher average BMI (P = 0.06). The rates of documented infection in overweight patients and non-overweight patients were not significantly different (53.3 vs. 62.8 %). The 5-year event-free survival (EFS) of overweight patients was superior to that of non-overweight patients (78.8 vs. 55.4 %). Patients (n = 11) who received hematopoietic stem cell transplantation (HSCT) in first remission (CR1) had a significantly higher 5-year EFS (87.5 vs. 55.2 %, P = 0.04). Among 47 children who did not receive HSCT in CR1, 10 (21.3 %) were overweight. The 5-year EFS of overweight patients was consistently superior to that for non-overweight patients (70.0 vs. 51.2 %). In conclusion, overweight/obese children with AML did not experience poor outcomes in the present study.

Severe malnutrition evaluated by patient-generated subjective global assessment results in poor outcome among adult patients with acute leukemia

“…Our results are in accordance with those of previous studies; [ 6 , 7 , 11 ] but disagree with the findings of others. [ 5 , 8 ] BMI and weight were widely used in studies focusing on the influence of nutritional status on survival time; however, the same conclusions were not reached in these studies, suggesting that these indexes may be unreliable for assessing severe malnutrition.…”

“…Diagnosis of malnutrition is a serious problem in patients with tumor including leukemia. Previous studies have showed that the influence of BMI on survival time differs from each other, [ 5 – 9 ] and other indexes such as weight and albumin are also unstable. [ 10 ] PG-SGA is highly recommended by nutritionists and can be easily applied in leukemia patients.…”

“…[ 3 , 4 ] Various nutritional evaluation tools such as body mass index (BMI), weight loss, biochemical indexes, and body composition are applied in different studies, yielding inconsistent results. [ 5 – 10 ] This situation is a main factor limiting leukemia-related nutritional research.…”

<p>A Review on the Impact of Body Mass Index on Outcomes in Pediatric Leukemia</p>

“…Despite the limited number of patients, this single-center experience reported comparable OS and EFS among the 3 BMI groups (underweight, n=3, healthy, n=40, overweight, n=15) (Chen 2015). 35 The Northern Society of Pediatric Hematology and Oncology described outcomes and toxicities after chemotherapy protocol AML 2004 and reported also the impact of BMI in 318 children. In this cohort, being overweight was associated with a higher risk of being bedridden and requiring supplemental oxygen (HR = 1.9, 95% CI = 1.0-3.5, p=0.04).…”

Validation of Different Nutritional Assessment Tools in Predicting Prognosis of Patients with Soft Tissue Spindle-Cell Sarcomas

“…Malnutrition is a main cause of poor prognosis [ 5 ]. Many nutritional examination tools including weight loss, body mass index, blood chemical analysis, and body composition are used to predict cancer prognoses, leading to inconsistent results [ 6 , 7 , 8 , 9 ]. The Geriatric Nutritional Risk Index (GNRI) is generated to examine risk of malnutrition-related complications in elderly patients [ 10 , 11 ], and is reportedly a significant predictor of prognosis in many diseases including cancer [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ].…”