患有急性髓性白血病的超重和体重不足儿童的死亡率
Beverly J Lange1, Robert B Gerbing, James Feusner
1Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pa 19104, USA. lange@email.chop.edu
JAMA
|January 13, 2005
概括
患有急性髓性白血病 (AML) 的体重不足或超重的儿童的生存率显著降低,治疗相关死亡率更高. 这些发现强调了体重指数 (BMI) 对儿科AML结果的关键影响.
科学领域:
- 儿科瘤学 儿科瘤学
- 血液学 血液学 血液学
- 临床研究 临床研究
背景情况:
- 治疗急性髓性白血病 (AML) 可以治愈大约一半的儿科患者.
- 与治疗相关的并发症导致儿科AML中5-15%的死亡.
- 患者体重对儿科AML结局的影响尚不清楚.
研究的目的:
- 根据诊断时的身体质量指数 (BMI) 来比较儿科AML患者的生存率.
- 调查体重不足 (BMI ≤10百分位),超重 (BMI ≥95百分位) 和中等体重 (BMI 11-94百分位) 群体之间的差异.
主要方法:
- 768名1至20岁的儿科AML患者的回顾性审查.
- 来自儿童癌症组-2961试验的体重指数 (BMI) 和生存数据的分析.
- 使用危险比率 (HRs) 调整以考虑混变量进行统计分析.
主要成果:
- 与中等体重患者相比,体重不足和超重的儿科AML患者的存活率明显较低.
- 体重不足患者的生存率为1.85HR,治疗相关死亡率为2.66HR.
- 超重患者的生存率为1.88HR,治疗相关死亡率为3.49HR.
- 早期化疗疗程中的感染是治疗相关死亡的主要原因.
结论:
- 与治疗相关的并发症显著降低了患有AML的体重不足和超重儿童的存活率.
- 体重指数 (BMI) 是影响儿科AML治疗结果的关键因素.
- 需要进一步的研究来优化低体重和超重儿童的AML治疗策略.
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