Relationship between obesity and clinical outcome in adults with acute myeloid leukemia: A pooled analysis from four<scp>CALGB</scp>(alliance) clinical trials

Castillo, Jorge J.; Mulkey, Flora; Geyer, Susan; Kolitz, Jonathan E.; Blum, William; Powell, Bayard L.; George, Stephen L.; Larson, Richard A.; Stone, Richard

doi:10.1002/ajh.24230

Cited by 46 publications

(65 citation statements)

References 33 publications

(33 reference statements)

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“…According to the literature, overweight and obesity may increase the risk of different kind of cancers, including acute myeloid leukemia . Moreover, within AML overweight and obesity seems to be more frequent in a group of APL patients . In this study, we can confirm, that the majority of APL patients are overweight or obese (59%).…”

Section: Discussionsupporting

confidence: 70%

“…Overweight/obesity is a frequent problem in a modern world. According to the literature, overweight and obesity may increase the risk of different kind of cancers, including acute myeloid leukemia . Moreover, within AML overweight and obesity seems to be more frequent in a group of APL patients .…”

Section: Discussionmentioning

confidence: 99%

“…Following the Wold Health Organization (WHO), overweight is defined by a body mass index (BMI) of 25‐29.9 kg/m 2 and obesity of ≥30 kg/m 2 . The association between overweight and obesity with an increased risk of over 20 different types of malignancies, including acute myeloid leukemia, has been described . It was previously reported that the percentage of obese patients with acute promyelocytic leukemia (APL) is higher than that observed in patients with non‐APL AML …”

Section: Introductionmentioning

confidence: 99%

“…Several studies have suggested worse clinical outcome in obese/overweight patients with APL. In particular, obesity/overweight has been related to shorter overall survival (OS), higher incidence of differentiation syndrome (DS) and an increased cumulative incidence of relapse (CIR) after front‐line therapy with ATRA and chemotherapy‐based protocols.…”

Section: Introductionmentioning

confidence: 99%

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Characteristics and outcome of adult patients with acute promyelocytic leukemia and increased body mass index treated with the PETHEMA Protocols

Sobas

Rodríguez‐Veiga

Vellenga

et al. 2020

European J of Haematology

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Objective The obesity/overweight may have an influence on APL outcomes. Methods This is the biggest multicentre analysis on 1320 APL patients treated with AIDA‐induction and risk‐adapted consolidation between 1996 and 2012. Patients body mass index (BMI) was classified as underweight (<18.5 kg/m2), normal (18.5‐25 kg/m2), overweight (25‐29.9 kg/m2), and obese (≥30 kg/m2) according to the World Health Organization (WHO) criteria. Results and conclusions Relationship between male gender, older age, and other known laboratory abnormalities in overweight/obese patients was significant. The induction mortality rate was significantly higher in APL with BMI ≥25 vs BMI <25 (10% vs 6%; P = .04). APL patients with BMI ≥25 had a trend to lower OS (74% vs 80%; P = .06). However, in the multivariate analysis, BMI did not retain the independent predictive value (P = .46). There was no higher incidence of differentiation syndrome with BMI ≥25, but there was a trend in obese. There was no difference in relapse rate according to the BMI. In summary, overweight/obesity does not represent an independent risk factor for APL outcomes. The influence of obesity in APL patients treated with chemotherapy‐free regimens remains to be established.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Characteristics and outcome of adult patients with acute promyelocytic leukemia and increased body mass index treated with the PETHEMA Protocols

Sobas

Rodríguez‐Veiga

Vellenga

et al. 2020

European J of Haematology

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“…Recent studies have suggested that obesity is a risk factor associated with AML. [1][2][3] Classically, karyotyping has formed a powerful independent prognostic indicator in this group of diseases. 4,5 It serves to identify biologically distinct subsets of disease and has been widely used to provide the framework for risk-adapted treatment approaches.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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CONTEXT: Complex karyotypes in acute myeloid leukemia (AML) are characterized by an overall low response rate with frequent relapses after clinical treatment. CASE REPORT: Here, we describe the case of a 61-year-old obese female with clinically diagnosed AML who presented a complex karyotype involving an uncommon abnormality: ring chromosome 11. Immunophenotypic analysis confirmed the diagnosis. Classical and molecular cytogenetic analyses, using GTG banding and FISH (fluorescence in situ hybridization), revealed the presence of complex structural rearrangement involving r(11), add(12)(p13), der(5) and der(13). CONCLUSION: Molecular cytogenetic analysis is suitable for better identification and characterization of chromosomal rearrangements in AML. Case reports like this, as well as population-based studies, are necessary for understanding the karyotypic changes that occur in humans.

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

Foran

Sun

Lai

et al. 2023

Cancer

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Background Obesity (body mass index [BMI] ≥30 kg/m2) is an important epidemiological risk factor for developing acute myeloid leukemia (AML). Therefore, the authors studied the association of obesity with clinical and genetic phenotype and its impact on outcome in adults with AML. Methods The authors analyzed BMI in 1088 adults who were receiving intensive remission induction and consolidation therapy in two prospective, randomized therapeutic clinical trials of the Eastern Cooperative Oncology Group‐American College of Radiology Imaging Network: E1900 (ClinicalTrials.gov identifier NCT00049517; patients younger than 60 years) and E3999 (ClinicalTrials.gov identifier NCT00046930; patients aged 60 years or older). Results Obesity was prevalent at diagnosis (33%) and, compared with nonobesity, was associated with intermediate‐risk cytogenetics group (p = .008), poorer performance status (p = .01), and a trend toward older age (p = .06). Obesity was not associated with somatic mutations among a selected 18‐gene panel that was tested in a subset of younger patients. Obesity was not associated with clinical outcome (including complete remission, early death, or overall survival), and the authors did not identify any patient subgroup that had inferior outcomes based on BMI. Obese patients were significantly more likely to receive <90% of the intended daunorubicin dose despite protocol specification, particularly in the E1900 high‐dose (90 mg/m2) daunorubicin arm (p = .002); however, this did not correlate with inferior overall survival on multivariate analysis (hazard ratio, 1.39; 95% confidence interval, 0.90–2.13; p = .14). Conclusions Obesity is associated with unique clinical and disease‐related phenotypic features in AML and may influence physician treatment decisions regarding daunorubicin dosing. However, the current study demonstrates that obesity is not a factor in survival, and strict adherence to body surface area‐based dosing is not necessary because dose adjustments do not affect outcomes.

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Relationship between obesity and clinical outcome in adults with acute myeloid leukemia: A pooled analysis from fourCALGB(alliance) clinical trials

Cited by 46 publications

References 33 publications

Characteristics and outcome of adult patients with acute promyelocytic leukemia and increased body mass index treated with the PETHEMA Protocols

Characteristics and outcome of adult patients with acute promyelocytic leukemia and increased body mass index treated with the PETHEMA Protocols

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

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

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