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Obesity is associated with residual leukemia following induction therapy for childhood B-precursor acute

Etan Orgel1, Jonathan Tucci2, Waseem Alhushki3

  • 1Children's Center for Cancer and Blood Disease, Children's Hospital Los Angeles, Los Angeles, CA; Jonathan Jaques Children's Cancer Center, Miller Children's Hospital Long Beach, Long Beach, CA; University of Southern California, Los Angeles, CA;

Blood
|October 29, 2014
PubMed

Insights

Obesity in children with B-precedent acute lymphoblastic leukemia (ALL) increases the risk of persistent minimal residual disease (MRD) and poorer event-free survival (EFS). This finding highlights the importance of weight status in pediatric ALL treatment outcomes.

Area of Science:

  • Pediatric Oncology
  • Hematology
  • Clinical Research

Background:

  • Obesity is linked to worse outcomes in pediatric acute lymphoblastic leukemia (ALL).
  • Persistent minimal residual disease (MRD) after induction therapy is a strong predictor of event-free survival (EFS) in ALL.

Purpose of the Study:

  • To investigate the association between obesity during induction chemotherapy and the risk of positive end-of-induction MRD in pediatric B-precursor ALL (BP-ALL).
  • To determine if obesity impacts EFS in children with BP-ALL, independent of MRD status.

Main Methods:

  • Analysis of end-induction bone marrow samples from 198 children with newly diagnosed BP-ALL treated with standard induction regimens.
  • Multidimensional flow cytometry (MDF) was used to assess MRD.
  • Body mass index (BMI) was evaluated as a predictor of MRD positivity and EFS.

Main Results:

  • Obesity at diagnosis was observed in 20.7% of the cohort.
  • Obesity was independently associated with a significantly higher risk of positive end-induction MRD (OR, 2.57; P = .016).
  • Both overweight and obesity were linked to poorer EFS, regardless of MRD status (P = .012).

Conclusions:

  • Obese children with newly diagnosed BP-ALL face an elevated risk of persistent MRD.
  • Obesity is associated with inferior EFS in pediatric BP-ALL patients.
  • Weight status should be considered in the management and prognostic assessment of pediatric ALL.

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