Amankwah Ernest K, Saenz Ashleigh M, Hale Gregory A, Brown Patrick A
a Clinical and Translational Research Organization, All Children's Research Institute, All Children's Hospital Johns Hopkins Medicine , St. Petersburg , FL , USA .
b Department of Pediatrics , Johns Hopkins University School of Medicine , Baltimore , MD , USA .
Leuk Lymphoma. 2016 May;57(5):1140-8. doi: 10.3109/10428194.2015.1076815. Epub 2015 Oct 9.
Obesity is a risk factor for mortality and relapse of certain cancers. However, existing evidence for pediatric leukemia is inconsistent. The aim of this systematic review and meta-analysis was to evaluate the association between obesity at diagnosis and pediatric acute leukemia mortality and relapse. This study systematically searched MEDLINE and EMBASE from inception to February 5, 2015. Random-effect models were used to generate pooled estimates of study-specific hazard ratios (HR) and 95% confidence intervals (CI). Eleven studies were included. An increased risk of mortality with a high BMI at diagnosis was observed (overall survival: HR=1.30, 95% CI=1.16-1.46 and event-free survival: HR=1.46, 95% CI=1.29-1.64). Only two studies reported HR for relapse; one reported a reduced risk, while the other reported an increased risk. A high BMI at diagnosis is associated with poor overall and event-free survival among pediatric acute leukemia patients. Targeted therapeutic approaches for obese pediatric leukemia patients may potentially improve survival outcomes.
肥胖是某些癌症死亡率和复发的一个风险因素。然而，关于小儿白血病的现有证据并不一致。本系统评价和荟萃分析的目的是评估诊断时肥胖与小儿急性白血病死亡率和复发之间的关联。本研究系统检索了从数据库建立至2015年2月5日的MEDLINE和EMBASE。采用随机效应模型生成各研究特异性风险比（HR）和95%置信区间（CI）的合并估计值。纳入了11项研究。观察到诊断时高BMI会增加死亡风险（总生存：HR=1.30，95%CI=1.16-1.46；无事件生存：HR=1.46，95%CI=1.29-1.64）。只有两项研究报告了复发的HR；一项报告风险降低，而另一项报告风险增加。诊断时高BMI与小儿急性白血病患者较差的总生存和无事件生存相关。针对肥胖小儿白血病患者的靶向治疗方法可能会改善生存结局。
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