Liu Qiuju, Major Brittny, Le-Rademacher Jennifer, Al-Kali Aref A, Alkhateeb Hassan, Begna Kebede, Elliott Michelle A, Gangat Naseema, Hogan William J, Hook C Christopher, Kaufmann Scott H, Pardanani Animesh, Patnaik Mrinal S, Tefferi Ayalew, Wolanskyj-Spinner Alexandra P, Wei Wei, Litzow Mark R
Department of Cancer Center, Division of Hematology, Jilin University, Changchun, Jilin, People's Republic of China.
Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
Blood Lymphat Cancer. 2021 Jan 22;11:1-9. doi: 10.2147/BLCTT.S269748. eCollection 2021.
Obesity is a worldwide problem that is related to cardiac disease, thrombosis and cancer. However, little is known about the impact of obesity on the outcomes of adult acute lymphoblastic leukemia (ALL) patients.
We retrospectively evaluated a cohort of 154 newly diagnosed adult ALL patients between 1994 and 2011 at Mayo Clinic (Rochester). According to the World Health Organization (WHO) international BMI classification, patients were stratified as underweight, normal weight, overweight, and obese. For some analyses, patients were also stratified according to a two-sided non-obese or obese classification.
The median follow-up time was 8.37 years. Obese patients were more likely to be women (p=0.024) and ≥60 years old (p=0.003). Five-year mortality rates were higher in obese patients than non-obese [HR 95% CI: 1.60 (1.03-2.50) p=0.035]. This was also the case in subgroup analysis among T-cell patients although the number of patients was small [HR 95% CI: 5.42 (1.84-15.98) p<0.001]. There was no difference in mortality among the B-cell patients. After adjusting for baseline variables, the difference in mortality remained in several models. There was no difference in EFS or cumulative incidence of relapse rates between obese and non-obese patients among the overall population.
In conclusion, our study suggests that adult ALL patients with obesity have lower survival rates, especially in T-cell ALL.
肥胖是一个全球性问题，与心脏病、血栓形成和癌症相关。然而，关于肥胖对成人急性淋巴细胞白血病（ALL）患者预后的影响知之甚少。
我们回顾性评估了1994年至2011年间在梅奥诊所（罗切斯特）新诊断的154例成人ALL患者队列。根据世界卫生组织（WHO）国际BMI分类，患者被分层为体重过轻、正常体重、超重和肥胖。在一些分析中，患者也根据双侧非肥胖或肥胖分类进行分层。
中位随访时间为8.37年。肥胖患者更可能为女性（p = 0.024）且年龄≥60岁（p = 0.003）。肥胖患者的五年死亡率高于非肥胖患者[风险比95%置信区间：1.60（1.03 - 2.50），p = 0.035]。在T细胞患者的亚组分析中也是如此，尽管患者数量较少[风险比95%置信区间：5.42（1.84 - 15.98），p < 0.001]。B细胞患者的死亡率没有差异。在对基线变量进行调整后，几种模型中死亡率的差异仍然存在。总体人群中肥胖和非肥胖患者的无事件生存期或复发率的累积发生率没有差异。
总之，我们的研究表明肥胖的成人ALL患者生存率较低，尤其是在T细胞ALL中。
