Impact of body mass index on outcome and treatment-related toxicity in young adults with acute lymphoblastic leukemia

Background: Data on outcome for patients in different body mass index (BMI) categories in young adults with acute lymphoblastic leukemia (ALL) are scarce. We explored survival and toxicities in different BMI categories in young adults with ALL.Material and methods: Patients aged 18-45 years, diagnosed with ALL between July 2008 and June 2022 in the Nordic countries, Estonia, or Lithuania, and treated according to the NOPHO ALL2008 protocol, were retrospectively enrolled and classified into different BMI categories. Endpoints were overall survival (OS), event-free survival (EFS) and cumulative incidence of relapse as well as incidence rate ratio (IRR) of severe predefined toxic events, and treatment delays.Results: The group comprised 416 patients, of whom 234 (56%) were stratified to non-high-risk (non-HR) treatment. In the non-HR group, patients with severe obesity, BMI & GE;35 kg/m2 had worse EFS due to relapses but there was no effect on toxicity or treatment delays compared with the healthy-weight patients. There was no association between BMI category and OS, overall toxicity, or treatment delays in the patients with high-risk treatment.Conclusion: Severe obesity is associated with worse EFS in young adults treated according to the non-HR arms of the NOPHO ALL2008 protocol. Poorer outcome is explained with a higher risk of relapse, possibly due to under treatment, and not caused by excess therapy-related mortality.

Hallböök, HeleneUppsala universitet,Hematologi(Swepub:uu)helehall (författare)
Heyman, MatsKarolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.;Karolinska Univ Hosp, Astrid Lindgren Childrens Hosp, Stockholm, Sweden. (författare)
Wartiovaara-Kautto, UllaUniv Helsinki, Area Hosp, HUS Comprehens Canc Ctr, Helsinki, Finland. (författare)
Quist-Paulsen, PetterNorwegian Univ Sci & Technol, Fac Med & Hlth Sci, Dept Clin & Mol Med, Trondheim, Norway. (författare)
Schmiegelow, KjeldUniv Hosp Rigshospitalet, Dept Pediat & Adolescent Med, Copenhagen, Denmark. (författare)
Griskevicius, LaimonasOncol & Transfus Med Ctr, Hematol, Vilnius, Lithuania. (författare)
Palk, KatrinNorth Estonia Med Ctr, Haematol Ctr, Tallinn, Estonia. (författare)
Toft, NinaUniv Copenhagen, Hosp Rigshospitalet, Dept Haematol, Copenhagen, Denmark. (författare)
Overgaard, Ulrik MaltheUniv Copenhagen, Hosp Rigshospitalet, Dept Haematol, Copenhagen, Denmark. (författare)
Harila-Saari, Arja H.Uppsala universitet,Barnonkologisk och neurologisk forskning(Swepub:uu)arjha456 (författare)
Ranta, SusannaKarolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.;Karolinska Univ Hosp, Astrid Lindgren Childrens Hosp, Stockholm, Sweden. (författare)
Karolinska InstitutetHematologi (creator_code:org_t)

Av författaren/redakt...: Egnell, Christin ...; Hallböök, Helene; Heyman, Mats; Wartiovaara-Kaut ...; Quist-Paulsen, P ...; Schmiegelow, Kje ...; visa fler...; Griskevicius, La ...; Palk, Katrin; Toft, Nina; Overgaard, Ulrik ...; Harila-Saari, Ar ...; Ranta, Susanna; visa färre...

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