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Associations between pretherapeutic body mass index, outcome, and cytogenetic abnormalities in pediatric acute myeloid leukemia.

  • Løhmann, Ditte J A1
  • Asdahl, Peter H1
  • Abrahamsson, Jonas2
  • Ha, Shau-Yin3
  • Jónsson, Ólafur G4
  • Kaspers, Gertjan J L5, 6, 7
  • Koskenvuo, Minna8
  • Lausen, Birgitte9
  • De Moerloose, Barbara10
  • Palle, Josefine11
  • Zeller, Bernward12
  • Sung, Lillian13
  • Hasle, Henrik1
  • 1 Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus N, Denmark. , (Denmark)
  • 2 Department of Pediatrics, Institution for Clinical Sciences, Queen Silvia Children's Hospital, Gothenburg, Sweden. , (Sweden)
  • 3 Department of Pediatrics, Queen Mary Hospital and Hong Kong Pediatric Hematology and Oncology Study Group (HKPHOSG), Hong Kong, China. , (China)
  • 4 Department of Pediatrics, Landspitali University Hospital, Reykjavik, Iceland. , (Iceland)
  • 5 Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands. , (Netherlands)
  • 6 Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands. , (Netherlands)
  • 7 Dutch Childhood Oncology Group, The Hague, The Netherlands. , (Netherlands)
  • 8 Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital and Helsinki University Central Hospital, Helsinki, Finland. , (Finland)
  • 9 Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. , (Denmark)
  • 10 Department of Pediatrics, Ghent University Hospital, Ghent, Belgium. , (Belgium)
  • 11 Department of Woman's and Children's Health, Uppsala University, Uppsala, Sweden. , (Oman)
  • 12 Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway. , (Norway)
  • 13 Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Canada. , (Canada)
Published Article
Cancer Medicine
Publication Date
Nov 01, 2019
DOI: 10.1002/cam4.2554
PMID: 31532076


Associations between body mass index (BMI), outcome, and leukemia-related factors in children with acute myeloid leukemia (AML) remain unclear. We investigated associations between pretherapeutic BMI, cytogenetic abnormalities, and outcome in a large multinational cohort of children with AML. We included patients, age 2-17 years, diagnosed with de novo AML from the five Nordic countries (2004-2016), Hong Kong (2007-2016), the Netherlands and Belgium (2010-2016), and Canada and USA (1995-2012). BMI standard deviations score for age and sex was calculated and categorized according to the World Health Organization. Cumulative incidence functions, Kaplan-Meier estimator, Cox regression, and logistic regression were used to investigate associations. In total, 867 patients were included. The median age was 10 years (range 2-17 years). At diagnosis, 32 (4%) were underweight, 632 (73%) were healthy weight, 127 (15%) were overweight, and 76 (9%) were obese. There was no difference in relapse risk, treatment-related mortality or overall mortality across BMI groups. The frequency of t(8;21) and inv(16) increased with increasing BMI. For obese patients, the sex, age, and country adjusted odds ratio of having t(8;21) or inv(16) were 1.9 (95% confidence interval (CI) 1.1-3.4) and 2.8 (95% CI 1.3-5.8), respectively, compared to healthy weight patients. This study did not confirm previous reports of associations between overweight and increased treatment-related or overall mortality in children. Obesity was associated with a higher frequency of t(8;21) and inv(16). AML cytogenetics appear to differ by BMI status. © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

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