Department of Hematology, Dr. Jose Eleuterio González University Hospital and School of Medicine, Universidad Autonoma de Nuevo León, Monterrey, México.
Clinical Nutrition, Dr. Jose Eleuterio González University Hospital and School of Medicine, Universidad Autonoma de Nuevo León, Monterrey, México.
Nutr Cancer. 2022;74(3):889-895. doi: 10.1080/01635581.2021.1934042. Epub 2021 Jun 27.
The impact of nutritional status at diagnosis of childhood acute lymphoblastic leukemia (ALL) on survival rates was assessed in a Hispanic cohort. Children <16 years with newly diagnosed ALL-B from 2011 to 2019 were studied. Overweight and obesity were classified by body mass index (BMI) and Z-score according to WHO and CDC criteria. BMI, weight percentiles for age and Z-Score were assessed using the WHO Anthro (0-5 years) and AnthroPlus (5-19 years) programs. Cox model was used to estimate risk factors for relapse and death; differences between groups were assessed with Student's T test for parametric and Mann-Whitney U test for non-parametric variables. Disease-free survival (DFS) and overall survival (OS) were determined by the Kaplan-Meier method, calculating time, status, cumulative survival and standard error with a 95% confidence interval. Equal data distribution was estimated with the log-rank test. One-hundred and seventy-two B-ALL children were studied. The overweight-obese group had a non-significant lower DFS (CDC: 54% vs. 60%, = 0.80; WHO: 57% vs. 64%, = 0.89) and OS rate (CDC:76% vs. 82%, = 0.38; WHO:65% vs. 81%, = 0.13). An association between nutritional status determined by CDC and WHO criteria at diagnosis of B-cell ALL and survival rates was not documented.
本研究评估了诊断时的营养状况对西班牙裔儿童急性淋巴细胞白血病(ALL)生存率的影响。纳入了 2011 年至 2019 年间新诊断为 ALL-B 的 16 岁以下儿童。超重和肥胖通过体重指数(BMI)和 Z 分数按照世界卫生组织(WHO)和疾病控制与预防中心(CDC)标准进行分类。BMI、年龄体重百分位数和 Z 分数使用 WHO Anthro(0-5 岁)和 AnthroPlus(5-19 岁)程序进行评估。使用 Cox 模型估计复发和死亡的风险因素;使用 Student's T 检验评估参数组间差异,使用 Mann-Whitney U 检验评估非参数组间差异。无病生存(DFS)和总生存(OS)通过 Kaplan-Meier 方法确定,计算时间、状态、累积生存率和 95%置信区间的标准误差。使用对数秩检验估计数据分布的均等性。共研究了 172 例 B-ALL 儿童。超重-肥胖组的 DFS(CDC:54%对 60%, = 0.80;WHO:57%对 64%, = 0.89)和 OS 率(CDC:76%对 82%, = 0.38;WHO:65%对 81%, = 0.13)差异无统计学意义。在 B 细胞 ALL 诊断时,CDC 和 WHO 标准确定的营养状况与生存率之间未发现关联。