University of Washington Medical Center, Seattle, WA, USA.
Leuk Lymphoma. 2013 Mar;54(3):541-6. doi: 10.3109/10428194.2012.717278. Epub 2012 Aug 22.
Increased body mass index (BMI) is associated with increased risk of treatment-related complications and inferior overall survival in patients with acute myeloid leukemia (AML). We retrospectively evaluated the association between percentage of ideal body weight (IBW) and complete remission (CR) among 63 newly diagnosed, previously untreated patients with AML. The median percentage of ideal body weight was 121% (range 86-246%). Thirty-three percent of patients were obese (≥ 130% IBW). In multivariate analysis, obesity was not associated with CR (odds ratio [OR] = 0.97, p = 0.88), overall survival (hazard ratio = 0.48, p = 0.52), platelet recovery by 30 days (OR = 1.14, p = 0.52) or neutrophil recovery by 30 days (OR = 1.12, p = 0.60). Obesity was also not associated with any differences in non-hematologic toxicity. CR rates were not significantly different comparing patients not dose-adjusted to patients with obesity-related adjustments (CR = 86% vs. 67%, p = 0.55). Empiric dose reductions based on obesity did not result in significantly different CR rates.
体重指数（BMI）升高与急性髓系白血病（AML）患者治疗相关并发症风险增加和总体生存不良相关。我们回顾性评估了 63 例新诊断、未经治疗的 AML 患者中理想体重百分比（IBW）与完全缓解（CR）之间的关系。理想体重的中位数百分比为 121%（范围 86-246%）。33%的患者肥胖（≥130%IBW）。多变量分析显示，肥胖与 CR（优势比 [OR] = 0.97，p = 0.88）、总体生存（风险比 = 0.48，p = 0.52）、30 天血小板恢复（OR = 1.14，p = 0.52）或 30 天中性粒细胞恢复（OR = 1.12，p = 0.60）无关。肥胖也与非血液学毒性无差异无关。未根据肥胖进行剂量调整的患者与肥胖相关调整的患者相比，CR 率无显著差异（CR = 86% vs. 67%，p = 0.55）。基于肥胖的经验性剂量减少并未导致 CR 率有显著差异。
