Paviglianiti Annalisa
Department of Hematology and Stem Cell Transplantation, Saint Antoine Hospital, AP-HP, Paris, France.
J Blood Med. 2020 Jun 18;11:205-212. doi: 10.2147/JBM.S232655. eCollection 2020.
In the last decades, adults and pediatric obesity have become a major issue in developed countries. Considerable research has been conducted in patients with acute lymphoblastic (ALL) and myeloid leukemia (AML) with the aim of correlating body mass index (BMI) and outcomes in patients undergoing chemotherapy for hematological diseases. In adults, a high BMI has been associated with increased leukemia-related mortality. Whether a similar effect exists in the pediatric setting remains controversial. Some of the studies detailed in this review have reported no differences in outcomes according to BMI, whilst other reports have described higher treatment-related mortality, increased risk of relapse and death. Although the link between BMI and acute leukemia outcomes is controversial, a large number of studies describe poorer survival rates in children with AML or ALL with higher BMI. On the other hand, being underweight has been associated with higher treatment-related toxicity. Understanding more about the impact of BMI in pediatric leukemia is of utmost importance to provide prompt intervention and improve outcomes.
在过去几十年中,成人和儿童肥胖已成为发达国家的一个主要问题。针对急性淋巴细胞白血病(ALL)和髓系白血病(AML)患者开展了大量研究,目的是将体重指数(BMI)与接受血液系统疾病化疗患者的预后相关联。在成人中,高BMI与白血病相关死亡率增加有关。在儿科环境中是否存在类似影响仍存在争议。本综述中详细介绍的一些研究报告称,根据BMI,预后没有差异,而其他报告则描述了更高的治疗相关死亡率、复发风险增加和死亡风险增加。尽管BMI与急性白血病预后之间的联系存在争议,但大量研究表明,BMI较高的AML或ALL儿童的生存率较差。另一方面,体重过轻与较高的治疗相关毒性有关。更多地了解BMI对小儿白血病的影响对于提供及时干预和改善预后至关重要。