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

(2019) CANCER MEDICINE. 8(15). p.6634-6643
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Abstract
Background: 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. Methods: 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. Results: 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. Conclusions: 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.
Keywords
CANADIAN INFECTIONS, SOCIOECONOMIC-STATUS, CHILDREN, CHILDHOOD, OVERWEIGHT, OBESITY, AML, MORTALITY, WEIGHT, METAANALYSIS, acute myeloid leukemia, body mass index, cytogenetic aberrations, mortality, pediatrics, recurrence

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MLA
Lohmann, Ditte JA, et al. “Associations between Pretherapeutic Body Mass Index, Outcome, and Cytogenetic Abnormalities in Pediatric Acute Myeloid Leukemia.” CANCER MEDICINE, vol. 8, no. 15, 2019, pp. 6634–43.
APA
Lohmann, D. J., Asdahl, P. H., Abrahamsson, J., Ha, S.-Y., Jonsson, O. G., Kaspers, G. J., … Hasle, H. (2019). Associations between pretherapeutic body mass index, outcome, and cytogenetic abnormalities in pediatric acute myeloid leukemia. CANCER MEDICINE, 8(15), 6634–6643.
Chicago author-date
Lohmann, Ditte JA, Peter H Asdahl, Jonas Abrahamsson, Shau-Yin Ha, Olafur G Jonsson, Gertjan JL Kaspers, Minna Koskenvuo, et al. 2019. “Associations between Pretherapeutic Body Mass Index, Outcome, and Cytogenetic Abnormalities in Pediatric Acute Myeloid Leukemia.” CANCER MEDICINE 8 (15): 6634–43.
Chicago author-date (all authors)
Lohmann, Ditte JA, Peter H Asdahl, Jonas Abrahamsson, Shau-Yin Ha, Olafur G Jonsson, Gertjan JL Kaspers, Minna Koskenvuo, Birgitte Lausen, Barbara De Moerloose, Josefine Palle, Bernward Zeller, Lillian Sung, and Henrik Hasle. 2019. “Associations between Pretherapeutic Body Mass Index, Outcome, and Cytogenetic Abnormalities in Pediatric Acute Myeloid Leukemia.” CANCER MEDICINE 8 (15): 6634–6643.
Vancouver
1.
Lohmann DJ, Asdahl PH, Abrahamsson J, Ha S-Y, Jonsson OG, Kaspers GJ, et al. Associations between pretherapeutic body mass index, outcome, and cytogenetic abnormalities in pediatric acute myeloid leukemia. CANCER MEDICINE. 2019;8(15):6634–43.
IEEE
[1]
D. J. Lohmann et al., “Associations between pretherapeutic body mass index, outcome, and cytogenetic abnormalities in pediatric acute myeloid leukemia,” CANCER MEDICINE, vol. 8, no. 15, pp. 6634–6643, 2019.
@article{8631523,
  abstract     = {Background: 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.
Methods: 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.
Results: 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.
Conclusions: 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.},
  author       = {Lohmann, Ditte JA and Asdahl, Peter H and Abrahamsson, Jonas and Ha, Shau-Yin and Jonsson, Olafur G and Kaspers, Gertjan JL and Koskenvuo, Minna and Lausen, Birgitte and De Moerloose, Barbara and Palle, Josefine and Zeller, Bernward and Sung, Lillian and Hasle, Henrik},
  issn         = {2045-7634},
  journal      = {CANCER MEDICINE},
  keywords     = {CANADIAN INFECTIONS,SOCIOECONOMIC-STATUS,CHILDREN,CHILDHOOD,OVERWEIGHT,OBESITY,AML,MORTALITY,WEIGHT,METAANALYSIS,acute myeloid leukemia,body mass index,cytogenetic aberrations,mortality,pediatrics,recurrence},
  language     = {eng},
  number       = {15},
  pages        = {6634--6643},
  title        = {Associations between pretherapeutic body mass index, outcome, and cytogenetic abnormalities in pediatric acute myeloid leukemia},
  url          = {http://dx.doi.org/10.1002/cam4.2554},
  volume       = {8},
  year         = {2019},
}

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