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International Journal of Hematology

09-03-2024 | Overweight | Original Article

Analysis of overweight/obese pediatric patients with acute myeloid leukemia: a report from the Japanese Pediatric Leukemia/Lymphoma Study Group AML-05 study

Authors: Hirozumi Sano, Keitaro Fukushima, Michihiro Yano, Shinya Osone, Yoko Kato, Daiichiro Hasegawa, Takako Miyamura, Shotaro Iwamoto, Hiroyuki Takahashi, Kiminori Terui, Akio Tawa, Daisuke Tomizawa

Published in: International Journal of Hematology

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Abstract

The dosage of chemotherapy drugs for overweight/obese children with acute myeloid leukemia (AML) has been empirically reduced based on ideal body weight (BW) in Japan to reduce the risk of adverse events. We investigated the associations between pre-therapeutic body mass index (BMI) and clinical outcomes among children with AML. A total of 280 children were divided into two groups based on the World Health Organization Child Growth Standards: a healthy-weight group (n = 254), and an overweight/obese group (n = 26). If BW exceeded 1.2 times the standard BW of Japanese children, the dosage of chemotherapy drugs was calculated using 1.2 times the standard BW. The dosage of chemotherapy drugs was reduced during at least one chemotherapy cycle in 24 of 26 patients (92.3%) in the overweight/obese group, compared with zero patients in the healthy-weight group. Overall/event-free survival, cumulative incidence of relapse, and treatment-related mortality (TRM) did not differ between the overweight/obese and healthy weight groups. However, the frequency of bacteremia was higher in the overweight/obese group (80.8 vs. 52.4%, P = 0.006). This indicates that TRM may increase when chemotherapy drug dosage is not corrected in overweight/obese patients. Drug reduction is a potential treatment strategy.
Literature
1.
Lange BJ, Smith FO, Feusner J, Barnard DR, Dinndorf P, Feiget S, et al. Outcomes in CCG-2961, a children’s oncology group phase 3 trial for untreated pediatric acute myeloid leukemia: a report from the children’s oncology group. Blood. 2008;111:1044–53.CrossRefPubMedPubMedCentral
2.
Lange BJ, Gerbing RB, Feusner J, Skolnik J, Sacks N, Smith FO, et al. Mortality in overweight and underweight children with acute myeloid leukemia. JAMA. 2005;293:203–11.CrossRefPubMed
3.
Orgel E, Genkinger JM, Aggarwal D, Sung L, Nieder M, Ladas EJ. Association of body mass index and survival in pediatric leukemia: a meta-analysis. Am J Clin Nutr. 2016;103:808–17.CrossRefPubMedPubMedCentral
4.
Amankwah EK, Saenz AM, Hale GA, Brown PA. Association between body mass index at diagnosis and pediatric leukemia mortality and relapse: a systematic review and meta-analysis. Leuk Lymphoma. 2016;57:1140–8.CrossRefPubMed
5.
Hunter RJ, Navo MA, Thaker PH, Bodurka DC, Wolf JK, Smith JA. Dosing chemotherapy in obese patients: actual versus assigned body surface area (BSA). Cancer Treat Rev. 2009;35:69–78.CrossRefPubMed
6.
Sparreboom A, Wolff AC, Mathijssen RHJ, Chatelut E, Rowinsky EK, Verweij J, et al. Evaluation of alternate size descriptors for dose calculation of anticancer drugs in the obese. J Clin Oncol. 2007;25:4707–13.CrossRefPubMed
7.
Colleoni M, Li S, Gelber RD, Price KN, Coates AS, Castiglione-Gertsch M, et al. Relation between chemotherapy dose, oestrogen receptor expression, and body-mass index. Lancet. 2005;366:1108–10.CrossRefPubMed
8.
Griggs JJ, Mangu PB, Anderson H, Balaban EP, Dignam JJ, Hryniuk WM, et al. Appropriate chemotherapy dosing for obese adult patients with cancer: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2012;30:1553–61.CrossRefPubMed
9.
Mapp S, Sandhu G, Carrington C, Hennig S. A systematic review of treatment outcomes with weight-based dosing of chemotherapy in obese adult patients with acute leukemia or lymphoma. Leuk Lymphoma. 2016;57:981–4.CrossRefPubMed
10.
Inaba H, Surprise HC, Pounds S, Cao X, Howard SC, Ringwald-Smith K, et al. Effect of body mass index on the outcome of children with acute myeloid leukemia. Cancer. 2012;118:5989–96.CrossRefPubMed
11.
Tomizawa D, Tawa A, Watanabe T, Saito AM, Kudo K, Taga T, et al. Excess treatment reduction including anthracyclines results in higher incidence of relapse in core binding factor acute myeloid leukemia in children. Leukemia. 2013;27:2413–6.CrossRefPubMed
12.
Kinoshita A, Miyachi H, Matsushita H, Yabe M, Taki T, Watanabe T, et al. Acute myeloid leukaemia with myelodysplastic features in children: a report of Japanese Paediatric Leukaemia/Lymphoma Study Group. Br J Haematol. 2014;167:80–6.CrossRefPubMed
13.
Shiba N, Ohki K, Kobayashi T, Hara Y, Yamato G, Tanoshima R, et al. High PRDM16 expression identifies a prognostic subgroup of pediatric acute myeloid leukemia correlated to FLT3-ITD, KMT2A-PTD, and NUP98-NSD1: the results of the Japanese Pediatric Leukemia/Lymphoma Study Group AML-05 trial. Br J Haematol. 2016;172:581–91.CrossRefPubMed
14.
Inokuchi M, Matsuo N, Anzo M, Hasegawa T. Body mass index reference values (mean and SD) for Japanese children. Acta Paediatr. 2007;96:1674–6.CrossRefPubMed
15.
Isojima T, Kato N, Ito Y, Kanzaki S, Murata M. Growth standard charts for Japanese children with mean and standard deviation (SD) values based on the year 2000 national survey. Clin Pediatr Endocrinol. 2016;25:71–6.CrossRefPubMedPubMedCentral
16.
de Onis M, Lobstein T. Defining obesity risk status in the general childhood population: which cut-offs should we use? Int J Pediatr Obes. 2010;5:458–60.CrossRefPubMed
17.
De Pauw B, Walsh TJ, Donnelly JP, Stevens DA, Edwards JE, Calandra T, et al. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer / Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis. 2008;46:1813–21.CrossRefPubMed
18.
Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant. 2013;48:452–8.CrossRefPubMed
19.
Kristensen DT, Nielsen LB, Jakobsen LHK, Kristensen TCC, Jepsen LØ, Schöllkopf C, et al. Effects of chemotherapy dose reductions in overweight patients with acute myeloid leukaemia: A Danish nationwide cohort study. Br J Haematol. 2022;199:539–48.CrossRefPubMedPubMedCentral
20.
21.
Dossett LA, Dageforde LA, Swenson BR, Metzger R, Bonatti H, Sawyer RG, et al. Obesity and site-specific nosocomial infection risk in the intensive care unit. Surg Infect (Larchmt). 2009;10:137–42.CrossRefPubMed
22.
Tsolakoglou I, Intas G, Stergiannis P, Sakkou A, Chalari E, Tsoumakas K, et al. Central-line-associated bloodstream infections (CLABSIs) incidence and the role of obesity: a prospective, observational Study in Greece. Adv Exp Med Biol. 2020;1196:11–8.CrossRefPubMed
23.
Falagas ME, Athanasoulia AP, Peppas G, Karageorgopoulos DE. Effect of body mass index on the outcome of infections: a systematic review. Obes Rev. 2009;10:280–9.CrossRefPubMed
24.
Tomizawa D, Tawa A, Watanabe T, Saito AM, Kudo K, Taga T, et al. Appropriate dose reduction in induction therapy is essential for the treatment of infants with acute myeloid leukemia: a report from the Japanese Pediatric Leukemia/Lymphoma Study Group. Int J Hematol. 2013;98:578–88.CrossRefPubMedPubMedCentral
Metadata
Title
Analysis of overweight/obese pediatric patients with acute myeloid leukemia: a report from the Japanese Pediatric Leukemia/Lymphoma Study Group AML-05 study
Authors
Hirozumi Sano
Keitaro Fukushima
Michihiro Yano
Shinya Osone
Yoko Kato
Daiichiro Hasegawa
Takako Miyamura
Shotaro Iwamoto
Hiroyuki Takahashi
Kiminori Terui
Akio Tawa
Daisuke Tomizawa
Publication date
09-03-2024
Publisher
Springer Nature Singapore
Published in
International Journal of Hematology
Print ISSN: 0925-5710
Electronic ISSN: 1865-3774
DOI
https://doi.org/10.1007/s12185-024-03745-9
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