The prognostic impact of anthropometrics in acute myeloid leukemia treated with intensive chemotherapy – A Danish nationwide cohort study

Kristensen, Daniel; Nielsen, Lise Drewes; Roug, Anne Stidsholt; Kristensen, Tove‐Christina Choe; Heath, Astrid; Jacobsen, Lasse; Nørgaard, Jan Maxwell; Jepsen, Lene Østergaard; Schöllkopf, Claudia; Theilgaard‐Mönch, Kim; Severinsen, Marianne Tang

doi:10.1016/j.leukres.2021.106567

Cited by 2 publications

(6 citation statements)

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“…Furthermore, we cannot exclude the possibility of residual confounding, or the existence of other covariates not captured or analysed resulting in unbalance between our groups. For example, the lack of mutational status because studies suggest that overweight could influence the mutational landscape including a lower frequency of high‐risk mutations such as TP53 ; however studies have previously shown that overweight does not influence survival in AML 8,40 . Additionally, we had no available information on cumulative doses contained in IC.…”

Section: Discussionmentioning

confidence: 99%

“…For example, the lack of mutational status because studies suggest that overweight could influence the mutational landscape including a lower frequency of high‐risk mutations such as TP53 ; however studies have previously shown that overweight does not influence survival in AML. 8 , 40 Additionally, we had no available information on cumulative doses contained in IC. This could potentially mask DR in our dataset since shortening of IC, for example, from daunorubicin plus cytarabine (DA) ‘7 + 3’ to ‘5 + 2’ also results in dose reductions.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, overweight among cancer patients has been associated with inferior overall survival (OS) 3,4 . While being overweight has been correlated with adverse clinical outcomes in acute promyelocytic leukaemia (APL), this association is more vague and conflicting for patients with non‐APL AML 5–8 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…3,4 While being overweight has been correlated with adverse clinical outcomes in acute promyelocytic leukaemia (APL), this association is more vague and conflicting for patients with non-APL AML. [5][6][7][8] Most antineoplastic agents are dosed according to an anthropometric parameter. In AML, dosing of IC has traditionally been calculated based on body surface area (BSA).…”

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confidence: 99%

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Effects of chemotherapy dose reductions in overweight patients with acute myeloid leukaemia: A Danish nationwide cohort study

et al. 2022

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Summary Overweight patients with cancer are frequently reduced in chemotherapy dose due to toxicity concerns, although previous studies have indicated that dose reduction (DR) of overweight patients results in comparable toxicity but may compromise overall survival (OS). Current evidence regarding DR in patients with acute myeloid leukaemia (AML) is limited. To investigate the association between DR and outcome among overweight patients with AML we analysed a Danish nationwide cohort of overweight adult AML patients treated with remission induction chemotherapy. Among 536 patients identified, 10.1% were categorized as DR defined as 95% or less of full body surface area (BSA)‐based dose. Risk factors for DR were high body mass index (BMI) and BSA, therapy‐related AML and favourable cytogenetics. No significant differences were observed for rates of complete remission (CR), 30‐ and 90‐day mortality between DR and non‐DR patients. Furthermore, DR did not affect median relapse‐free survival (RFS) [DR, 14.5 (95% confidence interval, 9.0–41.7) months; non‐DR, 15.0 (12.3–19.3)] with an adjusted difference in five‐year restricted mean survival time (Δ5y‐RMST) of 0.2 (−8.4 to 8.8) months nor median OS (DR, 17.0 [11.9 to 45.5] months; non‐DR, 17.5 [14.8 to 20.5]) with an adjusted Δ5y‐RMST of 0.8 (−5.7 to 7.3) months. In conclusion, we found no statistically significant association between DR and outcomes among overweight patients with AML. However, we acknowledge the limited sample size and encourage further studies in this important subject.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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Effects of chemotherapy dose reductions in overweight patients with acute myeloid leukaemia: A Danish nationwide cohort study

et al. 2022

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Socioeconomic Status and Overall Survival Among Patients With Hematological Malignant Neoplasms

Nielsen,

Kristensen,

Jakobsen

et al. 2024

JAMA Netw Open

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ImportanceIn recent years, there has been a focus on reducing the socioeconomic gap in survival for hematological malignant neoplasms. Understanding recent developments is important to develop further intervention to improve care.ObjectiveTo investigate the temporal trend in associations of socioeconomic status (SES) with survival among 3 aggressive hematological malignant neoplasms: multiple myeloma (MM), acute myeloid leukemia (AML), and diffuse large B-cell lymphoma (DLBCL).Design, Setting, and ParticipantsThis nationwide, population-based cohort study used retrospectively collected data from 3 clinical registries of patients diagnosed in Denmark between January 1, 2005, and December 31, 2020, with follow-up until December 31, 2021. Analyses were stratified by diagnosis year (2005-2009, 2010-2014, and 2015-2020). Participants were patients aged 25 to 65 years with hematological malignant neoplasms. Patients with missing data on education were excluded. Data were analyzed from October 14, 2022, to January 2, 2024.ExposureEducation was used as a proxy for SES and defined low- and high-SES groups based on the completion of tertiary education.Main Outcomes and MeasuresThe main outcome was overall survival (OS), analyzed using Kaplan-Meier (log rank) method and Cox proportional hazards regression adjusted for age, sex, performance status, comorbidities, and disease-specific prognostic indices. Two-year OS through time and survival difference were estimated using flexible parametric survival models.ResultsA total of 5677 patients (median [IQR] age, 58 [51-62] years; 3177 [57.0%] male) were assessed, including 1826 patients with MM, 1236 patients with AML, and 2509 patients with DLBCL. The 2-year OS increased over time for patients with MM (78.8% [95% CI, 75.4%-82.3%] to 91.4% [95% CI, 89.3%-93.5%]), AML (42.2% [95% CI, 37.8%-47.1%] to 52.7% [95% CI, 48.0%-57.9%]), and DLBCL (80.1% [95% CI, 77.4%-82.8%] to 88.1% [95% CI, 86.0%-90.3%]). For MM and DLBCL, no association of SES with survival was observed after adjustment (MM: hazard ratio [HR], 0.99 [95% CI, 0.85-1.15]; DLBCL: HR, 1.08 [95% CI, 0.91-1.29]). For AML, a negative association was observed between low SES and survival (HR, 1.49 [95% CI, 1.25-1.76]), but the association was attenuated in recent years. The difference in hazard for patients with low SES and AML was observed in the first 2 years after diagnosis.Conclusions and RelevanceThese findings suggest that survival has improved among patients with these hematological malignant neoplasms. While patients with MM and DLBCL had increased survival in all groups, disparities were observed in AML outcomes, primarily in the first years after diagnosis. These results suggest that differences originate in factors specific to AML.

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The prognostic impact of anthropometrics in acute myeloid leukemia treated with intensive chemotherapy – A Danish nationwide cohort study

Cited by 2 publications

References 16 publications

Effects of chemotherapy dose reductions in overweight patients with acute myeloid leukaemia: A Danish nationwide cohort study

Effects of chemotherapy dose reductions in overweight patients with acute myeloid leukaemia: A Danish nationwide cohort study

Socioeconomic Status and Overall Survival Among Patients With Hematological Malignant Neoplasms

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