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Obesity as a predic...
Obesity as a predictor of treatment-related toxicity in children with acute lymphoblastic leukaemia
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- Egnell, Christina (author)
- Karolinska Institutet,Karolinska Univ Hosp, Astrid Lindgren Childrens Hosp, Stockholm, Sweden.;Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.
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- Heyman, Mats (author)
- Karolinska Institutet,Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.
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- Jonsson, Olafur Gisli (author)
- Landspitali Univ Hosp, Childrens Hosp, Reykjavik, Iceland.
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- Raja, Raheel A. (author)
- Univ Hosp Rigshosp, Dept Pediat & Adolescent Med, Copenhagen, Denmark.;Univ Copenhagen, Fac Med, Inst Clin Med, Copenhagen, Denmark.
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- Niinimaki, Riitta (author)
- Oulu Univ Hosp, Med Res Ctr Oulu, PEDEGO Res Unit, Oulu, Finland.;Oulu Univ Hosp, Dept Children & Adolescents, Oulu, Finland.;Univ Oulu, Oulu, Finland.
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- Albertsen, Birgitte Klug (author)
- Aarhus Univ Hosp, Dept Paediat & Adolescent Med, Aarhus, Denmark.;Aarhus Univ, Dept Clin Med, Aarhus, Denmark.
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- Schmiegelow, Kjeld (author)
- Univ Hosp Rigshosp, Dept Pediat & Adolescent Med, Copenhagen, Denmark.;Univ Copenhagen, Fac Med, Inst Clin Med, Copenhagen, Denmark.
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- Stabell, Niklas (author)
- Univ Hosp North Norway, Dept Paediat, Tromso, Norway.
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- Vaitkeviciene, Goda (author)
- Santaros Klin & Vilnius Univ, Childrens Hosp, Affiliate Vilnius Univ Hosp, Vilnius, Lithuania.
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- Lepik, Kristi (author)
- Childrens Hosp, Dept Haematol & Oncol, Tallinn, Estonia.
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- Harila-Saari, Arja H. (author)
- Uppsala universitet,Barnonkologisk och neurologisk forskning
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- Ranta, Susanna (author)
- Karolinska Institutet,Karolinska Univ Hosp, Astrid Lindgren Childrens Hosp, Stockholm, Sweden.;Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.
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Karolinska Institutet Karolinska Univ Hosp, Astrid Lindgren Childrens Hosp, Stockholm, Sweden;Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden. (creator_code:org_t)
- 2021-11-02
- 2022
- English.
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In: British Journal of Haematology. - : John Wiley & Sons. - 0007-1048 .- 1365-2141. ; 196:5, s. 1239-1247
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Abstract
Subject headings
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- Obesity is associated with poor outcomes in childhood acute lymphoblastic leukaemia (ALL). We explored whether severe treatment-related toxicity and treatment delays could explain this observation. This study included 1 443 children aged 2 center dot 0-17 center dot 9 years with ALL treated with the Nordic Society of Pediatric Haematology and Oncology (NOPHO) ALL2008 non-high-risk protocol. Prospective treatment-related toxicities registered every three-month interval were used. Patients were classified according to sex- and age-adjusted international childhood cut-off values, corresponding to adult body mass index: underweight, <17 kg/m(2); healthy weight, 17 to <25 kg/m(2); overweight, 25 to <30 kg/m(2); and obese, >= 30 kg/m(2). Obese children had a higher incidence rate ratio (IRR) for severe toxic events {IRR: 1 center dot 55 [95% confidence interval (CI) 1 center dot 07-2 center dot 50]}, liver and kidney failures, bleeding, abdominal complication, suspected unexpected severe adverse reactions and hyperlipidaemia compared with healthy-weight children. Obese children aged >= 10 years had increased IRRs for asparaginase-related toxicities compared with healthy-weight older children: thromboses [IRR 2 center dot 87 (95% CI 1 center dot 00-8 center dot 21)] and anaphylactic reactions [IRR 7 center dot 95 (95% CI 2 center dot 15-29 center dot 37)] as well as higher risk for truncation of asparaginase [IRR 3 center dot 54 (95% CI 1 center dot 67-7 center dot 50)]. The high prevalence of toxicity and a higher risk of truncation of asparaginase may play a role in the poor prognosis of obese children aged >= 10 years with ALL.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Hematologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Hematology (hsv//eng)
Keyword
- body mass index
- obesity
- childhood acute lymphoblastic leukaemia
- adverse events
- toxicity
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Egnell, Christin ...
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Heyman, Mats
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Jonsson, Olafur ...
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Raja, Raheel A.
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Niinimaki, Riitt ...
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Albertsen, Birgi ...
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Schmiegelow, Kje ...
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Stabell, Niklas
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Vaitkeviciene, G ...
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Lepik, Kristi
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Harila-Saari, Ar ...
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Ranta, Susanna
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Hematology
- Articles in the publication
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British Journal ...
- By the university
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Uppsala University
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Karolinska Institutet