Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy.
Cancer Lett. 2013 Jun 1;333(1):32-5. doi: 10.1016/j.canlet.2012.12.018. Epub 2013 Jan 3.
Obesity, measured as body mass index (BMI), has been identified as a possible risk factor for several solid tumors as well as for chronic myeloid leukemia (CML). To date, no correlations have been reported in this latter disease between BMI at baseline and response to targeted therapies. We refer here on the impact of BMI on clinical response in 339 chronic phase (CP) CML patients treated with imatinib and 35 CP-CML patients treated frontline with nilotinib. If compared to patients with low BMI (<18.5-25), patients with increased BMI (>25-40) at diagnosis who received imatinib showed a significantly longer median time to achieve complete cytogenetic response (6.8 months vs 3.3 months, p=0.001), a reduced rate of major molecular response (77% vs 58%, p=0.01) which was also achieved in a longer median time (29 months compared to 14 months, p=0.01). Conversely, no differences were revealed with respect to BMI in patients treated frontline with nilotinib and also patients with increased BMI obtained rapidly CCyR and MMR with an incidence similar to that of underweight/normal weight patients. These results suggest that CML patients with increased weight at baseline should be followed and carefully monitored if treated with standard dose imatinib frontline for a possible early switch.
肥胖，用体重指数（BMI）来衡量，已被确定为几种实体肿瘤以及慢性髓性白血病（CML）的一个可能的危险因素。迄今为止，在这种疾病中，尚未有报道称基线 BMI 与靶向治疗的反应之间存在相关性。我们在这里提到 BMI 对接受伊马替尼治疗的 339 例慢性期（CP）CML 患者和 35 例一线接受尼洛替尼治疗的 CP-CML 患者的临床反应的影响。与低 BMI（<18.5-25）的患者相比，诊断时 BMI 较高（>25-40）的接受伊马替尼治疗的患者达到完全细胞遗传学缓解的中位时间明显更长（6.8 个月 vs 3.3 个月，p=0.001），主要分子缓解率降低（77% vs 58%，p=0.01），达到这一缓解的中位时间也更长（29 个月 vs 14 个月，p=0.01）。相反，在接受尼洛替尼一线治疗的患者以及 BMI 较高的患者中，BMI 与 CCyR 和 MMR 无关，这些患者获得 CCyR 和 MMR 的速度较快，且发生率与体重不足/正常体重患者相似。这些结果表明，基线体重较重的 CML 患者如果接受标准剂量伊马替尼一线治疗，应进行随访和密切监测，以便及早进行可能的换药。
