PMID- 32909636
OWN - NLM
STAT- MEDLINE
DCOM- 20210729
LR  - 20210729
IS  - 1600-0609 (Electronic)
IS  - 0902-4441 (Print)
IS  - 0902-4441 (Linking)
VI  - 105
IP  - 6
DP  - 2020 Dec
TI  - Impact of body mass index on relapse in children with acute lymphoblastic 
      leukemia treated according to Nordic treatment protocols.
PG  - 797-807
LID - 10.1111/ejh.13517 [doi]
AB  - OBJECTIVES: High body mass index (BMI) is associated with poorer survival in 
      childhood acute lymphoblastic leukemia (ALL), but the actual impact on the risk 
      of relapse still needs to be clarified. We evaluated the impact of BMI at 
      diagnosis on the risk of relapse in children with ALL treated according to Nordic 
      Society of Paediatric Haematology and Oncology (NOPHO) protocols. METHOD: In a 
      multicenter study, we collected data on BMI at diagnosis and outcome of 2558 
      children aged 2.0-17.9 years diagnosed between 1992 and 2016. Patients were 
      divided into four groups according to International Obesity Task Force (IOTF) 
      childhood BMI cut-offs: underweight, <17; healthy weight, 17-25; overweight, 
      25-30; and obese, >/=30 kg/m(2) . RESULTS: In Cox multivariate regression analyses, 
      an increased risk of relapse was observed in children aged 10-17.9 years with 
      unhealthy BMI at diagnosis (underweight hazard ratio HR: 2.90 [95% confidence 
      interval: 1.24-6.78], P = .01; overweight, HR: 1.95 [1.11-3.43], P = .02, and 
      obese HR: 4.32 [95% 2.08-8.97], P < .001), compared to children with healthy 
      weight. BMI had no impact on relapse in children under 10 years of age. 
      CONCLUSION: High BMI, and especially obesity at diagnosis, is an independent 
      adverse prognostic factor for relapse in older children with ALL.
CI  - (c) 2020 The Authors. European Journal of Haematology published by John Wiley & 
      Sons Ltd.
FAU - Egnell, Christina
AU  - Egnell C
AUID- ORCID: 0000-0003-1141-9053
AD  - Department of Women's and Children's Health, Karolinska Institutet, Stockholm, 
      Sweden.
AD  - Department of Pediatric Oncology, Astrid Lindgren Children's Hospital, Karolinska 
      University Hospital, Stockholm, Sweden.
FAU - Ranta, Susanna
AU  - Ranta S
AUID- ORCID: 0000-0001-7854-0371
AD  - Department of Women's and Children's Health, Karolinska Institutet, Stockholm, 
      Sweden.
AD  - Department of Pediatric Oncology, Astrid Lindgren Children's Hospital, Karolinska 
      University Hospital, Stockholm, Sweden.
FAU - Banerjee, Joanna
AU  - Banerjee J
AD  - Children and Adolescents Department, Helsinki University Hospital, Helsinki, 
      Finland.
FAU - Merker, Andrea
AU  - Merker A
AD  - Department of Women's and Children's Health, Karolinska Institutet, Stockholm, 
      Sweden.
FAU - Niinimaki, Riitta
AU  - Niinimaki R
AUID- ORCID: 0000-0003-0190-5664
AD  - PEDEGO Research Unit, Medical Research Center Oulu and Department of Children and 
      Adolescents, Oulu University Hospital and University of Oulu, Oulu, Finland.
FAU - Lund, Bendik
AU  - Lund B
AD  - Department of Pediatrics, St. Olavs University Hospital, and the Department of 
      Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, 
      Norwegian University of Science and Technology, Trondheim, Norway.
FAU - Mogensen, Pernille Rudebeck
AU  - Mogensen PR
AUID- ORCID: 0000-0002-5583-741X
AD  - Department of Pediatrics and Adolescent Medicine, University Hospital 
      Rigshospitalet, Copenhagen, Denmark.
FAU - Jonsson, Olafur G
AU  - Jonsson OG
AD  - Children's Hospital, Landspitali University Hospital, Reykjavik, Iceland.
FAU - Vaitkeviciene, Goda
AU  - Vaitkeviciene G
AD  - Children's Hospital, Affiliate of Vilnius University Hospital Santaros Klinikos 
      and Vilnius University, Vilnius, Lithuania.
FAU - Lepik, Kristi
AU  - Lepik K
AD  - Department of Haematology and Oncology, Tallin Children's Hospital, Tallin, 
      Estonia.
FAU - Forslund, Anders
AU  - Forslund A
AD  - Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
FAU - Heyman, Mats
AU  - Heyman M
AD  - Department of Women's and Children's Health, Karolinska Institutet, Stockholm, 
      Sweden.
AD  - Department of Pediatric Oncology, Astrid Lindgren Children's Hospital, Karolinska 
      University Hospital, Stockholm, Sweden.
FAU - Harila-Saari, Arja
AU  - Harila-Saari A
AUID- ORCID: 0000-0003-2767-5828
AD  - Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
LA  - eng
GR  - TJ2018-0093/Barncancerfonden/
PT  - Journal Article
DEP - 20200920
PL  - England
TA  - Eur J Haematol
JT  - European journal of haematology
JID - 8703985
SB  - IM
MH  - Adolescent
MH  - *Body Mass Index
MH  - Child
MH  - Child, Preschool
MH  - Clinical Decision-Making
MH  - Disease Management
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Obesity/complications
MH  - Overweight/complications
MH  - Precursor Cell Lymphoblastic 
      Leukemia-Lymphoma/complications/*epidemiology/pathology/therapy
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Recurrence
MH  - Registries
MH  - Scandinavian and Nordic Countries/epidemiology
PMC - PMC7693088
OTO - NOTNLM
OT  - acute lymphoblastic leukemia
OT  - body mass index
OT  - children
OT  - obesity
OT  - survival
COIS- There are no conflicts of interest to declare.
EDAT- 2020/09/11 06:00
MHDA- 2021/07/30 06:00
PMCR- 2020/11/27
CRDT- 2020/09/10 08:44
PHST- 2020/06/10 00:00 [received]
PHST- 2020/09/02 00:00 [revised]
PHST- 2020/09/03 00:00 [accepted]
PHST- 2020/09/11 06:00 [pubmed]
PHST- 2021/07/30 06:00 [medline]
PHST- 2020/09/10 08:44 [entrez]
PHST- 2020/11/27 00:00 [pmc-release]
AID - EJH13517 [pii]
AID - 10.1111/ejh.13517 [doi]
PST - ppublish
SO  - Eur J Haematol. 2020 Dec;105(6):797-807. doi: 10.1111/ejh.13517. Epub 2020 Sep 
      20.