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Impact of body mass index on relapse in children with acute lymphoblastic leukemia treated according to Nordic treatment protocols.

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Authors
Egnell, Christina
Ranta, Susanna
Banerjee, Joanna
Merker, Andrea
Niinimäki, Riitta
Lund, Bendik
Mogensen, Pernille Rudebeck
Jonsson, Ólafur G
Vaitkeviciene, Goda
Lepik, Kristi
Forslund, Anders
Heyman, Mats
Harila-Saari, Arja
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Issue Date
2020-09-20

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Egnell C, Ranta S, Banerjee J, Merker A, Niinimäki R, Lund B, Mogensen PR, Jonsson ÓG, Vaitkeviciene G, Lepik K, Forslund A, Heyman M, Harila-Saari A. Impact of body mass index on relapse in children with acute lymphoblastic leukemia treated according to Nordic treatment protocols. Eur J Haematol. 2020 Dec;105(6):797-807. doi: 10.1111/ejh.13517
Abstract
Objectives: High body mass index (BMI) is associated with poorer survival in childhood acute lymphoblastic leukemia (ALL), but the actual impact on the risk of relapse still needs to be clarified. We evaluated the impact of BMI at diagnosis on the risk of relapse in children with ALL treated according to Nordic Society of Paediatric Haematology and Oncology (NOPHO) protocols. Method: In a multicenter study, we collected data on BMI at diagnosis and outcome of 2558 children aged 2.0-17.9 years diagnosed between 1992 and 2016. Patients were divided into four groups according to International Obesity Task Force (IOTF) childhood BMI cut-offs: underweight, <17; healthy weight, 17-25; overweight, 25-30; and obese, ≥30 kg/m2 . Results: In Cox multivariate regression analyses, an increased risk of relapse was observed in children aged 10-17.9 years with unhealthy BMI at diagnosis (underweight hazard ratio HR: 2.90 [95% confidence interval: 1.24-6.78], P = .01; overweight, HR: 1.95 [1.11-3.43], P = .02, and obese HR: 4.32 [95% 2.08-8.97], P < .001), compared to children with healthy weight. BMI had no impact on relapse in children under 10 years of age. Conclusion: High BMI, and especially obesity at diagnosis, is an independent adverse prognostic factor for relapse in older children with ALL. Keywords: acute lymphoblastic leukemia; body mass index; children; obesity; survival.
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https://onlinelibrary.wiley.com/doi/10.1111/ejh.13517
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© 2020 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.
ae974a485f413a2113503eed53cd6c53
10.1111/ejh.13517
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