Obesity and Survival in a Cohort of Predominantly Hispanic Children With Acute Lymphoblastic Leukemia

University of Texas at San Antonio, San Antonio, Texas, United States
Journal of Pediatric Hematology/Oncology (Impact Factor: 0.9). 10/2006; 28(9):575-8. DOI: 10.1097/01.mph.0000212985.33941.d8
Source: PubMed


Acute lymphoblastic leukemia (ALL), the most common malignancy in children, constitutes 25% of all pediatric cancer. Childhood cancer patients who are obese at diagnosis represent a particular challenge for the oncologist. Obesity may complicate chemotherapy dose determination, and has been associated with decreased overall and event-free survival in a number of adult cancer patients, and more recently in pediatric patients. The purpose of the present study was to examine whether obesity at diagnosis was associated with decreased overall and event-free survival in a cohort of 322 predominantly Hispanic pediatric patients with B-precursor ALL. Obesity was classified as an age-standardized and sex-standardized body mass index z-score at or above the 95th percentile. Hazard ratios (HRs) for overall and event-free survival were assessed using Cox proportional hazards regression modeling. Obesity at diagnosis was not associated with decreased overall survival (HR = 1.40, 95% confidence interval = 0.69-2.87) or event-free survival (HR = 1.08, 95% confidence interval = 0.65-1.82) in the overall cohort or in either of the 2 age-at-diagnosis (2 to 9 y; 10 to 18 y) subgroups. Our finding of no obesity-related prognostic effect in the overall cohort and in the under 2 to 9-year age-at-diagnosis cohort was consistent with the previous large-scale study of ALL patients; the absence of a prognostic effect in the 10 to 18-year age-at-diagnosis cohort, however, conflicted with previous findings.

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    • "The association between obesity and leukemia prognosis has also been examined in many studies, with some detecting an effect of obesity to worsen prognosis, and others not (Table 1). Two of the studies acknowledged that their failure to detect an association between BMI and ALL outcome may have been due to small sample size (16, 17). Interestingly, the risk estimates of overall survival and event-free survival from both studies showed a trend of worsened outcome in the overweight/obese patients. "
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