The Impact of Obesity on the Outcomes of Adult Patients with Acute Lymphoblastic Leukemia – A Single Center Retrospective Study

Abstract

Introduction

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.

Methods

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.

Results

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.

Discussion

In conclusion, our study suggests that adult ALL patients with obesity have lower survival rates, especially in T-cell ALL.

Keywords:

• acute lymphoblastic leukemia
• obesity
• overweight
• B cell
• T cell

Acknowledgments

This work was supported in part by grants from the National Science Foundation of China (81302860, to Q.L.).

Disclosure

Dr Scott H Kaufmann reports grants from National Cancer Institute, Eli Lilly, Cyteir Therapeutics, Stand Up to Cancer/Entertainment Industry Foundation/AACR, and Minnesota Partnership for Biotechnology and Medical Genomics; non-financial support from ProLynx LLC, outside the submitted work. In addition, Dr Scott H Kaufmann has EP Patent No. 1682131 issued to Wyeth/Pfizer, US Patent No. 8530172 issued, US Patent No. 8729048 issued, US Patent No. 62/149873 pending, US Patent No. 62/312115 pending, and US Patent No. 62/668508 pending. The authors report no other conflicts of interest in this work.