Obesity in adult acute myeloid leukemia is not associated with inferior response or survival even when dose capping anthracyclines: An ECOG‐ACRIN analysis
Year: 2023
Type: article
Abstract: Background Obesity (body mass index [BMI] ≥30 kg/m2) is an important epidemiological risk factor for developing acute myeloid leukemia (AML). Therefore, the authors studied the association of obesity with clinical and genetic phenotype and its impact on outcome in adults with AML. Methods The authors analyzed BMI in 1088 adults who were receiving intensive remission induction and consolidation therapy in two prospective, randomized therapeutic clinical trials of the Eastern Cooperative Oncology Group‐American College of Radiology Imaging Network: E1900 (ClinicalTrials.gov identifier NCT00049517; patients younger than 60 years) and E3999 (ClinicalTrials.gov identifier NCT00046930; patients aged 60 years or older). Results Obesity was prevalent at diagnosis (33%) and, compared with nonobesity, was associated with intermediate‐risk cytogenetics group (p = .008), poorer performance status (p = .01), and a trend toward older age (p = .06). Obesity was not associated with somatic mutations among a selected 18‐gene panel that was tested in a subset of younger patients. Obesity was not associated with clinical outcome (including complete remission, early death, or overall survival), and the authors did not identify any patient subgroup that had inferior outcomes based on BMI. Obese patients were significantly more likely to receive <90% of the intended daunorubicin dose despite protocol specification, particularly in the E1900 high‐dose (90 mg/m2) daunorubicin arm (p = .002); however, this did not correlate with inferior overall survival on multivariate analysis (hazard ratio, 1.39; 95% confidence interval, 0.90–2.13; p = .14). Conclusions Obesity is associated with unique clinical and disease‐related phenotypic features in AML and may influence physician treatment decisions regarding daunorubicin dosing. However, the current study demonstrates that obesity is not a factor in survival, and strict adherence to body surface area‐based dosing is not necessary because dose adjustments do not affect outcomes.
Source: Cancer
DOI: 10.1002/cncr.34807
Institutions: Mayo Clinic in Florida, Mayo Clinic Comprehensive Cancer Center (Florida), Eastern Cooperative Oncology Group, Dana-Farber Cancer Institute, Abramson Cancer Center, University of Pennsylvania, Moffitt Cancer Center, Indiana University Health, Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indiana University, Mayo Clinic, Montefiore Medical Center, University Hospitals of Cleveland, University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Memorial Sloan Kettering Cancer Center, University of Rochester Medicine, Shaare Zedek Medical Center, Bikur Cholim Hospital, Northwestern University, Robert H. Lurie Comprehensive Cancer Center of Northwestern University
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Awards: G1464043166, ECOG-ACRIN Network Group Operations Center, G1974211183, MINORITY-BASED COMMUNITY ONCOLOGY PROGRAM, G2398472636, G2819266960, G3100437649, G3475623468, Network Lead Academic Participating Site: Memorial Sloan Kettering Cancer Center, G6413627522, G6705915398, G7850080506, G803893432, G8220656038, G9000012443, G9000035362, G9000257314, G9000280145, G9000327439, Cancer Center Support Grant
OpenAlex ID: W4367054331