身体质量指数(BMI)之间的关联,结果,急性髓系白血病(AML)患儿的白血病相关因素尚不清楚。我们调查了治疗前BMI,细胞遗传学异常,以及一个大型多国AML儿童队列的结果。
我们包括患者,年龄2-17岁,来自五个北欧国家(2004-2016年),香港(2007-2016),荷兰和比利时(2010-2016),加拿大和美国(1995-2012)。根据世界卫生组织对年龄和性别的BMI标准差评分进行计算和分类。累积发生率函数,卡普兰-迈耶估计器,Cox回归,和逻辑回归用于调查相关性。
总共,包括867名患者。中位年龄为10岁(范围2-17岁)。诊断时,32人(4%)体重不足,632(73%)体重健康,127(15%)超重,和76(9%)肥胖。复发风险没有差异,BMI组的治疗相关死亡率或总死亡率。t(8;21)和inv(16)的频率随BMI的增加而增加。对于肥胖患者,性,年龄,t(8;21)或inv(16)的国家调整后比值比分别为1.9(95%置信区间(CI)1.1-3.4)和2.8(95%CI1.3-5.8),分别,与健康体重的患者相比。
这项研究没有证实以前关于超重与儿童治疗相关死亡率或总死亡率增加之间的关联的报道。肥胖与t(8;21)和inv(16)的较高频率相关。AML细胞遗传学似乎因BMI状态而异。
Associations between body mass index (BMI), outcome, and leukemia-related factors in children with acute myeloid leukemia (AML) remain unclear. We investigated associations between pretherapeutic BMI, cytogenetic abnormalities, and outcome in a large multinational cohort of children with AML.
We included patients, age 2-17 years, diagnosed with de novo AML from the five Nordic countries (2004-2016), Hong Kong (2007-2016), the Netherlands and Belgium (2010-2016), and Canada and USA (1995-2012). BMI standard deviations score for age and sex was calculated and categorized according to the World Health Organization. Cumulative incidence functions, Kaplan-Meier estimator, Cox regression, and logistic regression were used to investigate associations.
In total, 867 patients were included. The median age was 10 years (range 2-17 years). At diagnosis, 32 (4%) were underweight, 632 (73%) were healthy weight, 127 (15%) were overweight, and 76 (9%) were obese. There was no difference in relapse risk, treatment-related mortality or overall mortality across BMI groups. The frequency of t(8;21) and inv(16) increased with increasing BMI. For obese patients, the sex, age, and country adjusted odds ratio of having t(8;21) or inv(16) were 1.9 (95% confidence interval (CI) 1.1-3.4) and 2.8 (95% CI 1.3-5.8), respectively, compared to healthy weight patients.
This study did not confirm previous reports of associations between overweight and increased treatment-related or overall mortality in children. Obesity was associated with a higher frequency of t(8;21) and inv(16). AML cytogenetics appear to differ by BMI status.