Sallati Isabela, Abend Bardagi Julia, Mendonça José Alexandre, Degasperi Giovanna R
School of Life Sciences, Pontifical Catholic University of Campinas, Campinas, SP, Brazil.
School of Medicine, Pontifical Catholic University of Campinas, Campinas, SP, Brazil.
J Pediatr Endocrinol Metab. 2025 Apr 29. doi: 10.1515/jpem-2024-0448.
The prevalence of overweight and obesity in childhood is a health challenge. This condition induces alterations in adipose tissue and metabolic disorders such as diabetes, dyslipidemia, and hypertension even in childhood and may also be associated with cancer development. Underlying mechanisms related to childhood cancer, such as leukemia and obesity, are not entirely understood.
Considering this scenario, a systematic literature review was performed on the PubMed library. Studies that evaluate the association between overweight or obesity at diagnosis of childhood leukemia and the outcomes associated with this condition were included.
In some studies, a worse prognosis was observed in obese children compared to non-obese, which begs the question of how the adipose tissue environment may be involved with leukemia progression and its outcomes such as relapse, overall and event-free survival and infections.
Obesity in children diagnosed with leukemia may be associated with poor outcomes during disease progression as reported in some studies. The remodeling and composition of adipose tissue, alterations in adipocytokines secretion, such as leptin, and inflammation that may trigger awakened oncogenes seem to be important players in cancer development and outcomes during treatment. Understanding if there is any relationship between adipose tissue and the development of childhood leukemia and its prognosis, as well as the biological mechanisms of this scenario, is important to contribute to improving the treatment protocols and survival, especially in obese children.
儿童超重和肥胖的流行是一项健康挑战。这种情况会导致脂肪组织发生改变，并引发代谢紊乱，如糖尿病、血脂异常和高血压，甚至在儿童期就会出现，还可能与癌症发展有关。与儿童癌症（如白血病和肥胖）相关的潜在机制尚未完全明确。
考虑到这种情况，我们在PubMed数据库中进行了系统的文献综述。纳入了评估儿童白血病诊断时超重或肥胖与该疾病相关预后之间关系的研究。
在一些研究中，观察到肥胖儿童的预后比非肥胖儿童更差，这就引出了一个问题，即脂肪组织环境可能如何参与白血病的进展及其预后，如复发、总生存率和无事件生存率以及感染情况。
如一些研究报道，被诊断患有白血病的儿童肥胖可能与疾病进展期间的不良预后相关。脂肪组织的重塑和组成、脂肪细胞因子（如瘦素）分泌的改变以及可能触发致癌基因激活的炎症，似乎在癌症发展和治疗期间的预后中起着重要作用。了解脂肪组织与儿童白血病发展及其预后之间是否存在任何关系，以及这种情况的生物学机制，对于改进治疗方案和提高生存率，特别是肥胖儿童的生存率至关重要。
