Department of Hematology and Oncology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
Am J Hematol. 2013 Aug;88(8):642-6. doi: 10.1002/ajh.23462. Epub 2013 May 30.
Acute myeloid leukemia (AML) is more common and more lethal among patients over the age of 60. Increased body mass index (BMI) has been associated with a higher incidence of various malignancies, including AML. We sought to determine whether patient BMI at the time of AML diagnosis is related to overall survival (OS) among elderly patients. We identified 97 patients with AML diagnosed after the age of 60 and treated with cytarabine-based induction chemotherapy. The median age was 68 years (range 60-87); 52% of patients were male, and our study population was predominantly white (89% of patients). The median OS for all patients was 316 days (95% CI 246-459). The hazard ratio for mortality was increased among patients with a BMI < 25 compared to BMI ≥ 30 (HR 2.14, P = 0.009, 95% CI 1.21-3.77), as well as with older age (HR 1.76, P = 0.015, 95% CI 1.12-2.79) and with secondary versus de novo disease (HR 1.95, P = 0.006, 95% CI 1.21-3.14). After multivariable analysis, we did not find a significant association between OS and other potential confounders such as coronary artery disease or diabetes among these patients. We conclude that increased BMI was independently associated with improved OS among older AML patients at our institution.
急性髓细胞白血病（AML）在 60 岁以上患者中更为常见且致命。较高的体重指数（BMI）与各种恶性肿瘤的发病率增加有关，包括 AML。我们试图确定 AML 诊断时患者的 BMI 是否与老年患者的总生存率（OS）有关。我们确定了 97 名在 60 岁以上被诊断为 AML 并接受基于阿糖胞苷的诱导化疗的患者。中位年龄为 68 岁（范围 60-87）；52%的患者为男性，我们的研究人群主要为白人（89%的患者）。所有患者的中位 OS 为 316 天（95%CI 246-459）。与 BMI≥30 的患者相比，BMI<25 的患者的死亡率风险比增加（HR 2.14，P=0.009，95%CI 1.21-3.77），年龄较大（HR 1.76，P=0.015，95%CI 1.12-2.79）和继发性疾病与初发性疾病相比（HR 1.95，P=0.006，95%CI 1.21-3.14）。多变量分析后，我们未发现 OS 与这些患者中其他潜在混杂因素（如冠状动脉疾病或糖尿病）之间存在显著关联。我们得出结论，在我们的机构中，较高的 BMI 与老年 AML 患者的 OS 改善独立相关。
