#Leukemia #Cancer #BMI #Obesity #Malnutrition #Oncology
Obesity and malnutrition in children are increasing worldwide. Recent
data suggest that these factors may influence the progression of many diseases,
including
pediatric cancers. Among them,
acute leukemia—comprising
acute
lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML)—remains the most
common form. While therapeutic advances have significantly improved survival
rates, some
factors influencing treatment response remain poorly understood.
Although
body mass index (BMI) is recognized as a risk factor in several
adult cancers, its
impact on the prognosis of pediatric leukemias remains
underexplored. Obesity, for instance, may induce
chronic inflammation and alter
chemotherapy pharmacokinetics, whereas malnutrition may weaken patients by
reducing immune reserves and treatment tolerance.
This study aims to
analyze the influence of BMI at diagnosis on the
clinical outcomes and survival of children with acute leukemia by assessing its
effects on
mortality, event-free survival, and relapse risk.
Read next: ALL: a constantly evolving battle
Weight and leukemia: a risky duo?
This study is based on a
meta-analysis of 17 studies involving
pediatric
leukemia patients. The data were analyzed to assess the impact of
BMI at
diagnosis on three key criteria:
overall survival, event-free survival, and
relapse risk.
The analysis reveals that both
obese and underweight children have an
increased risk of mortality compared to those with a
normal BMI.
Findings indicate that underweight children have an
increased mortality
risk with a hazard ratio (HR) of 1.07, while obesity is associated with an HR
of 1.42.
Event-free survival is also reduced, with an HR of 1.10 for
underweight children and 1.34 for obesity. However,
no significant differences
were observed in relapse risk, regardless of weight status.
These results suggest that
BMI at diagnosis may influence treatment
response, highlighting the importance of
appropriate nutritional management
from the start of the therapeutic journey.
BMI: a key prognostic factor?
Pediatric acute leukemia is the
most common childhood cancer. Despite
significant therapeutic advances that have improved survival rates, several
factors influencing treatment response remain poorly understood.
BMI could play
a key role in disease progression. While
obesity promotes
chronic inflammation
and metabolic alterations, malnutrition weakens immune defenses and reduces
treatment tolerance. However, the precise impact of these imbalances on
leukemia survival and progression remains unclear.
This study aims to
assess the influence of BMI at diagnosis on
overall
survival, event-free survival, and relapse risk in children with leukemia.
The findings show that
obese or underweight children at diagnosis have
an
increased risk of mortality and lower event-free survival compared to
patients with a
normal BMI. However,
no link was found between BMI and relapse
risk.
Nonetheless, major limitations persist.
Variations in BMI definitions
across studies complicate result interpretation, while
socioeconomic factors
and differences in patient management were not uniformly analyzed. Further
research is needed to better understand the impact of nutritional status on
treatment response. Integrating
nutritional care from the time of diagnosis
could not only improve survival in children with leukemia but also reduce
complications associated with weight imbalances.
Read next: Burden of disease attributable to high body mass index: an analysis of data from the Global Burden of Disease Study 2021
