Overweight as a prognostic factor in children with acute lymphoblastic leukemia

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Cristina B Gelelete1, Sandra H Pereira, Alice Maria B Azevedo

  • 1Pediatrics Institute IPPMG, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. elainesc@centroin.com.br

Obesity (Silver Spring, Md.)
|July 2, 2011
PubMed

Insights

Overweight and obesity in children with acute lymphoblastic leukemia (ALL) independently predict a higher risk of relapse, particularly in intermediate and high-risk groups. This finding impacts long-term event-free survival (EFS) in pediatric ALL patients.

Area of Science:

  • Pediatric Oncology
  • Hematology
  • Clinical Research

Background:

  • Acute lymphoblastic leukemia (ALL) is a common childhood cancer.
  • Event-free survival (EFS) is a critical measure of treatment success in pediatric ALL.
  • The prognostic role of overweight/obesity in pediatric ALL requires further investigation.

Purpose of the Study:

  • To determine the prognostic impact of overweight/obesity on 5-year EFS in children with ALL.
  • To assess whether overweight/obesity is an independent predictor of relapse risk in pediatric ALL.
  • To explore potential biological mechanisms linking overweight/obesity to ALL relapse.

Main Methods:

  • Retrospective analysis of 181 newly diagnosed pediatric ALL patients.
  • Patients were treated with Berlin-Frankfurt-Munich (BFM) protocols between 1990 and 2009.
  • Analysis focused on the relationship between overweight/obesity status and 5-year EFS, stratified by risk group.

Main Results:

  • Overweight/obesity was identified as an independent predictor of relapse risk.
  • This association was most pronounced in the intermediate- and high-risk (HR) groups.
  • Results suggest a significant impact on 5-year event-free survival (EFS) in these pediatric ALL patients.

Conclusions:

  • Overweight/obesity negatively impacts EFS in pediatric ALL by increasing relapse risk.
  • Potential mechanisms include altered chemotherapy pharmacokinetics and adipocyte-mediated antiapoptotic effects in leukemic cells.
  • Clinical management and risk stratification for pediatric ALL may need to consider patient weight status.

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