Obesity appeared greatly associated along with shorter DFS and OS among adult patients along with acute promyelocytic leukemia, according to a pooled analysis of four clinical trials published in American Diary of Hematology.
However, the association did not persist in patients along with non-acute promyelocytic leukemia (non-APL) acute myeloid leukemia, according to the researchers.
Jorge J. Castillo, MD
“APL has actually gone from being the the majority of deadly leukemia form to being the one along with much better opportunities of cure,” Jorge J. Castillo, MD, assistant professor of medicine at Harvard Medical School and medical professional at Dana-Farber Cancer Institute, told HemOnc Today. “Despite these advances, APL continues associated along with early mortality associated with the ailment itself or complications from treatment. Obesity is a global epidemiological problem, and there have actually been smaller sized studies that have actually revealed increased risk of producing APL in overweight people also as even worse survival.”
Thus, Castillo and colleagues sought to assess the effect of obesity on survival speeds in AML and APL. To do so, they performed a meta-analysis of four prospective studies conducted by the Cancer and Leukemia Group B (CALGB).
The effect of obesity on OS, DFS and clinical outcomes offered as the primary endpoint.
The study included data from 2,173 adult patients along with AML. 3 studies — CALGB 9621 (n = 393; age range, 18-59 years), CALGB 10503 (n = 541; age range, 18-60) and CALGB 19808 (n = 714; age range, 18-59) — included patients along with de novo AML. The others remaining study, CALGB 9710 (n = 446; age range, 18-80), included patients along with de novo APL.
The researchers defined obesity as a BMI of 30 or greater. Fifty percent of patients along with APL and 38% of patients along with non-APL AML were considered obese.
Among patients along with APL, overweight patients endured poorer DFS (HR = 1.53; 95% CI, 1.03-2.27) and OS (HR = 1.72; 95% CI, 1.15-2.58) after adjusting for others relevant factors, including age, sex, race, ethnicity, performance status and baseline white blood cell count.
However, among patients along with non-APL AML, weight did not appear associated along with DFS or OS outcomes.
The researchers acknowledged limitations of their study. Due to the fact that their analysis was restricted to patients that enrolled in a CALGB trial, their outcomes could not be generalizable to every one of patients along with APL or AML. Further, they noted that non-Caucasians were underrepresented in the trials included.
“Potential next research actions contain the usage of a reasonable fat diet regimen while on treatment for APL to reduce differentiation syndrome or others problems,” Castillo said. “A study conducted in Italy has actually currently revealed preclinical incentives of reasonable fat diet regimen in leukemic mice undergoing therapy for APL. Obesity has actually been associated along with a lot of ailment and conditions and has actually come to be a significant public good health and a stabilized diet regimen and upkeep of a healthy and balanced weight is highly encouraged.” – by Cameron Kelsall
For much more information:
Jorge J. Castillo, MD, can easily be reached at Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA 02215; email: jorgej_castillo@dfci.harvard.edu.
Disclosure: Castillo reports research funding from Gilead, Millennium Pharmaceuticals and Pharmacyclics, also as consultant roles along with Biogen Idec and Otsuka. One others study researcher reports consultant roles along with Abbvie, Agios, Amgen, Arrog, Bristol-Myers Squibb, Celator, Genentech, Karyopharm, Merck and Pfizer.
