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肥胖与儿童B前体急性淋巴细胞白血病诱导治
肥胖与儿童急性淋巴细胞白血病（ALL）较差的无事件生存（EFS）相关。本研究纳入历史队列中接受儿童肿瘤组诱导方案治疗的例儿童新诊断B前体ALL（BP-ALL）患者，并对这些患者诱导治疗末期骨髓样本的多维流式细胞检测结果进行了分析。研究者评估了体重指数（BMI）对诱导末期骨髓微小残留病灶（MRD）阳性风险的影响。结果显示，诊断时有30例患者超重（15.2%），41例患者肥胖（20.7%）。诱导治疗期间，肥胖与高MRD显著相关（比值比：2.57，95%可信区间：1.19-5.54，p=0.），可作为独立且确定的治疗反应预测因素。研究表明，新诊断BP-ALL肥胖患儿诱导末期MRD阳性风险增高且EFS更差。
该研究提前在线发表于年10月27日《血液》杂志上（Blood.Oct27.[Epubaheadofprint]）。
ObesityisassociatedwithresidualleukemiafollowinginductiontherapyforchildhoodB-precursoracutelymphoblasticleukemia.
Blood.Oct27.pii:blood--08-.[Epubaheadofprint]
OrgelE(1),TucciJ(2),AlhushkiW(3),MalvarJ(1),
Obesityisassociatedwithpoorerevent-freesurvival(EFS)inpediatricacutelymphoblasticleukemia(ALL).Persistentminimalresidualdisease(MRD)inthebonemarrowasmeasuredbymultidimensionalflowcytometry(MDF)isakeyearlyprognosticindicatorandisstronglyassociatedwithEFS.WethereforehypothesizedthatobesityduringinductionwouldbeassociatedwithpositiveendofinductionMRD(≥0.01%).WeanalyzedMDFofend-inductionbonemarrowsamplesfromahistoricalcohortofchildrennewlydiagnosedwithB-precursorALL(BP-ALL)andtreatedwithChildrensOncologyGroupinductionregimens.Weassessedtheinfluenceofbodymassindex(BMI)onriskforpositiveend-inductionMRDinthebonemarrow.InourcohortofBP-ALL,30childrenwereoverweight(15.2%)and41obese(20.7%)atdiagnosis.Independentofestablishedpredictorsoftreatmentresponse,obesityduringinductionwasassociatedwithsignificantlygreaterriskforpersistentMRD(OddsRatio2.57,95%ConfidenceInterval1.19-5.54,p=0.).ObesityandoverweightwereassociatedwithpoorerEFSirrespectiveofend-inductionMRD(p=0.).ObesechildrenwithnewlydiagnosedBP-ALLareatincreasedriskforpositiveend-inductionMRDandpoorerEFS.
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