| Title |
Obesity as a predictor of treatment-related toxicity in children with acute lymphoblastic leukaemia / |
| Authors |
Egnell, Christina ; Heyman, Mats ; Jónsson, Ólafur Gisli ; Raja, Raheel A ; Niinimäki, Riitta ; Albertsen, Birgitte Klug ; Schmiegelow, Kjeld ; Stabell, Niklas ; Vaitkevičienė, Goda Elizabeta ; Lepik, Kristi ; Harila-Saari, Arja ; Ranta, Susanna |
| DOI |
10.1111/bjh.17936 |
| Full Text |
|
| Is Part of |
British journal of haematology.. Hoboken : Wiley-Blackwell. 2022, vol. 196, no. 5, p. 1239-12479.. ISSN 0007-1048. eISSN 1365-2141 |
| Keywords [eng] |
adverse events ; body mass index ; childhood acute lymphoblastic leukaemia ; obesity ; toxicity |
| Abstract [eng] |
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 2·0-17·9 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/m2 ; healthy weight, 17 to <25 kg/m2 ; overweight, 25 to <30 kg/m2 ; and obese, ≥30 kg/m2 . Obese children had a higher incidence rate ratio (IRR) for severe toxic events {IRR: 1·55 [95% confidence interval (CI) 1·07-2·50]}, 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 2·87 (95% CI 1·00-8·21)] and anaphylactic reactions [IRR 7·95 (95% CI 2·15-29·37)] as well as higher risk for truncation of asparaginase [IRR 3·54 (95% CI 1·67-7·50)]. 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. |
| Published |
Hoboken : Wiley-Blackwell |
| Type |
Journal article |
| Language |
English |
| Publication date |
2022 |
| CC license |
|
