title: Influence of obesity on efficacy and toxicity of induction chemotherapy in patients with newly diagnosed acute myeloid leukemia.
abstract: Increased body mass index (BMI) is associated with increased risk of treatment-related complications and inferior overall survival in patients with acute myeloid leukemia (AML). We retrospectively evaluated the association between percentage of ideal body weight (IBW) and complete remission (CR) among 63 newly diagnosed, previously untreated patients with AML. The median percentage of ideal body weight was 121% (range 86-246%). Thirty-three percent of patients were obese (≥ 130% IBW). In multivariate analysis, obesity was not associated with CR (odds ratio [OR] = 0.97, p = 0.88), overall survival (hazard ratio = 0.48, p = 0.52), platelet recovery by 30 days (OR = 1.14, p = 0.52) or neutrophil recovery by 30 days (OR = 1.12, p = 0.60). Obesity was also not associated with any differences in non-hematologic toxicity. CR rates were not significantly different comparing patients not dose-adjusted to patients with obesity-related adjustments (CR = 86% vs. 67%, p = 0.55). Empiric dose reductions based on obesity did not result in significantly different CR rates.
authors.affiliation: University of Washington Medical Center, Seattle, WA, USA. lina@mskcc.org
authors.forename: Andrew
authors.initials: A
authors.lastname: Lin
authors.forename: Megan
authors.initials: M
authors.lastname: Othus
authors.forename: Amy
authors.initials: A
authors.lastname: McQuary
authors.forename: Mary
authors.initials: M
authors.lastname: Chi
authors.forename: Elihu
authors.initials: E
authors.lastname: Estey
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D015992:Body Mass Index; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D003630:Daunorubicin / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005260:Female; D005334:Fever / Q000139:chemically induced; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage / Q000009:adverse effects; D060828:Induction Chemotherapy; D007951:Leukemia, Myeloid / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009503:Neutropenia / Q000139:chemically induced; D009765:Obesity / Q000503:physiopathology*; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012074:Remission Induction; D055815:Young Adult
chemical_list: D003561:Cytarabine; D015255:Idarubicin; D003630:Daunorubicin