PMID- 30362242
OWN - NLM
STAT- MEDLINE
DCOM- 20191106
LR  - 20200309
IS  - 1545-5017 (Electronic)
IS  - 1545-5009 (Print)
IS  - 1545-5009 (Linking)
VI  - 66
IP  - 2
DP  - 2019 Feb
TI  - Obesity in pediatric patients with acute lymphoblastic leukemia increases the 
      risk of adverse events during pre-maintenance chemotherapy.
PG  - e27515
LID - 10.1002/pbc.27515 [doi]
AB  - PURPOSE: Obesity correlates with adverse events (AEs) in children with acute 
      myelogenous leukemia and during maintenance therapy for acute lymphoblastic 
      leukemia (ALL). Less is known about AEs in obese ALL patients during 
      pre-maintenance chemotherapy. We evaluated the relationship between obesity (body 
      mass index (BMI) >/= 95th percentile) and AEs during pre-maintenance chemotherapy 
      in pediatric patients with ALL. METHODS: One hundred fifty-five pediatric ALL 
      patients diagnosed at a single institution between 2006 and 2012 were 
      retrospectively evaluated for infections, treatment-requiring hypertension, 
      insulin-requiring hyperglycemia, pancreatitis, pediatric intensive care unit 
      admissions, sepsis, febrile neutropenia (FN) admissions, thrombosis, 
      hepatotoxicity, and nephrotoxicity. Univariate and multivariable analyses 
      compared proportions of obese versus nonobese patients experiencing AEs. RESULTS: 
      AEs occurring significantly more frequently in obese patients by univariate 
      analysis included treatment-requiring hypertension (17.5% vs 6.1%; OR, 3.27; 95% 
      CI, 1.1-10.0, P = 0.0497) and insulin-requiring hyperglycemia (25.0% vs 11.3%; 
      OR, 2.62; 95% CI, 1.04-6.56, P = 0.04). Obese patients had greater incidence 
      rates for recurrent admission-requiring infections (incidence rate ratio (IRR) 
      1.64; 95% CI, 1.08-2.48, P = 0.02) and recurrent FN admissions (IRR, 1.53; 95% 
      CI, 1.10-2.12, P = 0.01). Accounting for combined age and NCI risk status, 
      obesity was a risk factor for treatment-requiring hypertension (OR, 3.90; 95% CI, 
      1.19-12.76, P = 0.02), insulin-requiring hyperglycemia (OR, 3.92; 95% CI, 
      1.39-11.05, P = 0.01), and FN admission (OR, 2.92; 95% CI, 1.27-6.73, P = 0.01). 
      CONCLUSIONS: During pre-maintenance chemotherapy for ALL, obesity is a risk 
      factor for the development of hypertension, hyperglycemia, and FN admissions. 
      This research provides implications for augmented preventive and supportive care 
      guidelines in obese ALL patients.
CI  - (c) 2018 Wiley Periodicals, Inc.
FAU - Meenan, Chelsea K
AU  - Meenan CK
AUID- ORCID: 0000-0002-2899-8816
AD  - University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
FAU - Kelly, John A
AU  - Kelly JA
AD  - University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
FAU - Wang, Li
AU  - Wang L
AD  - Clinical and Translational Sciences Institute, University of Pittsburgh, 
      Pittsburgh, Pennsylvania.
FAU - Ritchey, A Kim
AU  - Ritchey AK
AD  - Department of Pediatrics, Division of Pediatric Hematology/Oncology, University 
      of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
FAU - Maurer, Scott H
AU  - Maurer SH
AD  - Clinical and Translational Sciences Institute, University of Pittsburgh, 
      Pittsburgh, Pennsylvania.
AD  - Department of Pediatrics, Division of Pediatric Hematology/Oncology, University 
      of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
LA  - eng
GR  - UL1 TR000005/TR/NCATS NIH HHS/United States
GR  - UL1-TR-000005/NH/NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20181026
PL  - United States
TA  - Pediatr Blood Cancer
JT  - Pediatric blood & cancer
JID - 101186624
RN  - 0 (Antineoplastic Agents)
SB  - IM
MH  - Adolescent
MH  - Antineoplastic Agents/*adverse effects
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Male
MH  - Obesity/*complications
MH  - Precursor Cell Lymphoblastic Leukemia-Lymphoma/*complications/*drug therapy
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Young Adult
PMC - PMC6301108
MID - NIHMS992033
OTO - NOTNLM
OT  - acute lymphoblastic leukemia
OT  - adverse events
OT  - obesity
OT  - pediatric
COIS- CONFLICT OF INTEREST The authors declare that there is no conflict of interest.
EDAT- 2018/10/27 06:00
MHDA- 2019/11/07 06:00
PMCR- 2020/02/01
CRDT- 2018/10/27 06:00
PHST- 2017/09/11 00:00 [received]
PHST- 2018/09/07 00:00 [revised]
PHST- 2018/09/24 00:00 [accepted]
PHST- 2018/10/27 06:00 [pubmed]
PHST- 2019/11/07 06:00 [medline]
PHST- 2018/10/27 06:00 [entrez]
PHST- 2020/02/01 00:00 [pmc-release]
AID - 10.1002/pbc.27515 [doi]
PST - ppublish
SO  - Pediatr Blood Cancer. 2019 Feb;66(2):e27515. doi: 10.1002/pbc.27515. Epub 2018 
      Oct 26.