Chen Shih-Hsiang, Jaing Tang-Her, Hung Iou-Jih, Yang Chao-Ping, Chang Tsung-Yen
Division of Hematology/Oncology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5 Fu-Shin Street, Kwei-Shan, 333, Taoyuan, Taiwan,
Int J Hematol. 2015 Jul;102(1):48-52. doi: 10.1007/s12185-015-1795-z. Epub 2015 Apr 5.
Overweight/obese patients with acute myeloid leukemia (AML) are reported as experiencing inferior outcomes and greater numbers of treatment-related complications. We retrospectively studied 58 children with newly diagnosed AML who received chemotherapy at Chang Gung Memorial Hospital between January 2003 and December 2011. Patients enrolled were considered overweight if body mass index (BMI) was ≥85th percentile. Fifteen of 58 (25.9 %) patients were judged overweight by this criterion. Patients diagnosed in the last third of this period (2009-2011) had a higher average BMI (P = 0.06). The rates of documented infection in overweight patients and non-overweight patients were not significantly different (53.3 vs. 62.8 %). The 5-year event-free survival (EFS) of overweight patients was superior to that of non-overweight patients (78.8 vs. 55.4 %). Patients (n = 11) who received hematopoietic stem cell transplantation (HSCT) in first remission (CR1) had a significantly higher 5-year EFS (87.5 vs. 55.2 %, P = 0.04). Among 47 children who did not receive HSCT in CR1, 10 (21.3 %) were overweight. The 5-year EFS of overweight patients was consistently superior to that for non-overweight patients (70.0 vs. 51.2 %). In conclusion, overweight/obese children with AML did not experience poor outcomes in the present study.
据报道，超重/肥胖的急性髓系白血病（AML）患者预后较差，且治疗相关并发症更多。我们回顾性研究了2003年1月至2011年12月在长庚纪念医院接受化疗的58例新诊断AML儿童患者。如果体重指数（BMI）≥第85百分位数，则纳入的患者被认为超重。58例患者中有15例（25.9%）根据该标准被判定为超重。在此期间最后三分之一（2009 - 2011年）诊断的患者平均BMI较高（P = 0.06）。超重患者和非超重患者的记录感染率无显著差异（53.3%对62.8%）。超重患者的5年无事件生存率（EFS）优于非超重患者（78.8%对55.4%）。首次缓解期（CR1）接受造血干细胞移植（HSCT）的患者（n = 11）5年EFS显著更高（87.5%对55.2%，P = 0.04）。在47例CR1期未接受HSCT的儿童中，10例（21.3%）超重。超重患者的5年EFS始终优于非超重患者（70.0%对51.2%）。总之，在本研究中，超重/肥胖的AML儿童患者并未出现不良预后。
