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Ann Hematol (2012) 91:359365 DOI 10.1007/s00277-011-1319-8
ORIGINAL ARTICLE
Is obesity a prognostic factor for acute myeloid leukemia outcome?
Hun Ju Lee & Andrea S. Licht & Andrew J. Hyland & Laurie A. Ford & Sheila N. J. Sait &
AnneMarie W. Block & Maurice Barcos & Maria R. Baer & Eunice S. Wang &
Meir Wetzler
Received: 17 March 2011 /Accepted: 22 August 2011 /Published online: 21 September 2011 # Springer-Verlag 2011
Abstract Obesity adversely affects outcome in pediatric acute lymphocytic leukemia and acute myeloid leukemia (AML). We asked if obesity, measured by body mass index (BMI), affected outcome in 329 adult AML patients treated with high-dose cytarabine and idarubicin-containing regimens administered according to actual body weight. Age60, unfavorable karyotype, secondary AML, and positive smoking status had adverse impact on overall survival in a multivariate analysis, while BMI did not. We conclude that high BMI should not be a barrier to administer high-dose cytarabine-containing regimens for AML induction.
Keywords Acute myeloid leukemia . Obesity. Body mass index . Outcome
Introduction
The prevalence of obesity has increased substantially over the past few decades and has more than doubled in adults in the USA [1]. Furthermore, obesity is a known risk factor for adult hematological malignancies [2]. Chemotherapy dosages for obese patients are often empirically reduced on the basis of ideal body weight because of concerns about excessive toxicity; however, dose reductions may compromise treatment outcomes [3, 4]. There is a paucity of information on the influence of body mass index (BMI) on the toxicity of intensive chemotherapy in adult AML and on progression-free survival (PFS) and overall survival (OS) following intensive chemotherapy [5, 6]. We compared toxicity data and survival outcomes across three BMI groups [normal (NL), overweight (OW), and obese (OB)], in 329 adults with AML, treated with similar AML induction chemotherapy administered by actual weights, to find out if obesity is a prognostic factor in AML.
Patients and methods
We queried the leukemia database for patients treated with high-dose cytarabine and idarubicin-containing regimens at the Roswell Park Cancer Institute (RPCI) between June 1990 and December 2008. Three hundred twenty-nine AML (except acute promyelocytic leukemia) patients eligible for high-dose cytarabine and idarubicin-containing regimens were found. The following patient data were scored: age, gender, weight,...