Young patients with a high body mass index (BMI) have a reduced survival rate after treatment for acute lymphoblastic leukaemia, new research has found.
A US-based study was carried out on 388 patients ages 15 to 50 years, collectively referred to as adolescents and young adults (AYAs). The cohort were treated on Dana-Farber Consortium paediatric regimens between 2008-2021, which included the medication asparaginase.
Among participants, 53% had a normal body mass index, and 47% were overweight or obese. The overweight/obese group had significantly higher non-relapse related mortality and lower rates of event-free survival and overall survival, the researchers report.
This risk was seen particularly in the older members of the AYA group, those aged 30 to 50 years.
Normal body mass index is associated with excellent outcomes regardless of age, the researchers stress.
AYA patients who were overweight or obese also had higher rates of serious toxicity from treatment, and high blood pressure.
First author, Dr Shai Shimony of the Dana-Farber Cancer Institute, Massachusetts, USA, said: “We have known for roughly fifteen years that obesity affects survival in paediatric patients but we wanted more granular data on this, to understand why this correlation exists, and how dependent it is on age.
“Moving forward, we hope that measures of obesity will be considered a vital variable in determining the most suitable treatment regimens for each individual patient.”
Shimony S, Flamand Y, Valtis YK, Place AE, Silverman LB, Vrooman LM, Brunner AM, Sallan SE, Stone RM, Wadleigh M, Neuberg DS, DeAngelo DJ, Luskin MR. (2023) “Effect of BMI on Toxicities and Survival Among Adolescents and Young Adults Treated on DFCI Consortium ALL Trials.” Blood Advances, doi: 10.1182/bloodadvances.2023009976
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