急性早幼粒细胞白血病（APL）中肥胖症的高发率：对 APL 和代谢综合征分化剂的影响。
High Prevalence of Obesity in Acute Promyelocytic Leukemia (APL): Implications for Differentiating Agents in APL and Metabolic Syndrome.
机构信息
Department of Pathology, Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, TN, USA.
出版信息
Ther Adv Hematol. 2011 Jun;2(3):141-5. doi: 10.1177/2040620711408490.
BACKGROUND
Between January 1999 and December 2008, 469 patients treated for acute myeloid leukemia (AML) were included in this single-institution study.
METHODS
We performed a case-control analysis to study the rate of obesity among patients with acute promyelocytic leukemia (APL) and non-APL AML.
RESULTS
A total of 81% of APL patients analyzed were obese compared with 41.7% in the non-APL group (p < 0.001). Body mass index (BMI) >30 was seen in 57% of APL patients compared with 31% for the non-APL group (p = 0.01). Neither obesity nor the chemotherapy dosing based on ideal body weight affected survival.
CONCLUSIONS
Our findings generate the hypothesis that APL and metabolic syndromes may share a common pathogenic pathway via retinoic acid receptors (RARs), the ligand-controlled transcription factors that function as heterodimers with retinoid X receptors (RXRs) to regulate cell growth and survival. If this link is confirmed in larger studies, our data will instigate further studies using RXR and RAR modulators as a preventive strategy among obese individuals.
背景
1999 年 1 月至 2008 年 12 月，共有 469 例急性髓细胞白血病（AML）患者接受了本机构的治疗。
方法
我们进行了病例对照分析，研究了急性早幼粒细胞白血病（APL）和非 APL AML 患者中肥胖的发生率。
结果
在接受分析的 APL 患者中，肥胖患者占 81%，而非 APL 组为 41.7%（p<0.001）。57%的 APL 患者体重指数（BMI）>30，而非 APL 组为 31%（p=0.01）。肥胖或根据理想体重进行化疗剂量调整均不影响生存。
结论
我们的发现提出了一个假设，即 APL 和代谢综合征可能通过视黄酸受体（RARs）共享一个共同的致病途径，RARs 是配体控制的转录因子，与视黄醇 X 受体（RXRs）形成异二聚体，调节细胞生长和存活。如果在更大的研究中证实了这一联系，我们的数据将促使进一步研究使用 RXR 和 RAR 调节剂作为肥胖个体的预防策略。
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