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Multicenter Study
. 2019 Jul 18;19(1):708.
doi: 10.1186/s12885-019-5878-8.

Overweight and obesity as predictors of early mortality in Mexican children with acute lymphoblastic leukemia: a multicenter cohort study

Juan Carlos Núñez-Enríquez  1 , Ana Elena Gil-Hernández  1 , Elva Jiménez-Hernández  2 , Arturo Fajardo-Gutiérrez  1 , Aurora Medina-Sansón  3 , Janet Flores-Lujano  1 , Laura Eugenia Espinoza-Hernández  2 , David Aldebarán Duarte-Rodríguez  1 , Raquel Amador-Sánchez  4 , José Gabriel Peñaloza-González  5 , José Refugio Torres-Nava  6 , Rosa Martha Espinosa-Elizondo  7 , Luz Victoria Flores-Villegas  8 , Laura Elizabeth Merino-Pasaye  8 , María Luisa Pérez-Saldivar  1 , Elisa María Dorantes-Acosta  3 , Beatriz Cortés-Herrera  7 , Karina Anastacia Solis-Labastida  9 , Nora Nancy Núñez-Villegas  2 , Martha Margarita Velázquez-Aviña  5 , Angélica Rangel-López  10 , Ana Itamar González-Ávila  4 , Jessica Denisse Santillán-Juárez  11 , Alejandra Jimena García-Velázquez  11 , Silvia Jiménez-Morales  12 , Vilma Carolina Bekker-Méndez  13 , Haydee Rosas-Vargas  14 , Minerva Mata-Rocha  14 , Omar Alejandro Sepúlveda-Robles  14 , Jorge Alfonso Martín-Trejo  15 , Juan Manuel Mejía-Aranguré  16   17
Affiliations
Multicenter Study

Overweight and obesity as predictors of early mortality in Mexican children with acute lymphoblastic leukemia: a multicenter cohort study

Juan Carlos Núñez-Enríquez et al. BMC Cancer. .

Abstract

Background: Mexico City has one of the highest incidences and mortality rates of acute lymphoblastic leukemia (ALL) in the world and a high frequency of early relapses (17%) and early mortality (15%). Otherwise, childhood overweight and obesity are reaching epidemic proportions. They have been associated with poor outcomes in children with ALL. The aim of present study was to identify if overweight and obesity are predictors of early mortality and relapse in Mexican children with ALL.

Methods: A multicenter cohort study was conducted. ALL children younger than 15 years old were included and followed-up during the first 24 months after diagnosis. Overweight and obesity were classified according World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) criteria. Early mortality and early relapses were the main outcomes.

Results: A total of 1070 children were analyzed. Overweight/obesity at diagnosis were predictors of early mortality (WHO: HR = 1.4, 95%CI:1.0-2.0; CDC: HR = 1.6, 95%CI:1.1-2.3). However, no associations between overweight (WHO: HR = 1.5, 95%CI:0.9-2.5; CDC: HR = 1.0; 95% CI:0.6-1.6) and obesity (WHO: HR = 1.5, 95%CI:0.7-3.2; CDC: HR = 1.4; 95%CI:0.9-2.3) with early relapse were observed.

Conclusions: Overweight and obese patients embody a subgroup with high risk of dying during leukemia treatment.

Keywords: Children; Early mortality; Leukemia; Mexico; Obesity; Overweight.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Disease-free survival (early relapses) according to CDC 2000 nutritional classification (three categories)
Fig. 2
Fig. 2
Disease-free-survival (early relapses) according to CDC 2000 (two categories)
Fig. 3
Fig. 3
Overall survival up to 24 months according to CDC nutritional status
Fig. 4
Fig. 4
Disease free-survival (early relapses) according to WHO nutritional classification
Fig. 5
Fig. 5
Overall survival up to 24 months after diagnosis according to WHO nutritional classification
See this image and copyright information in PMC

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