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

• Main Authors: Juan Carlos Núñez-Enríquez, Ana Elena Gil-Hernández, Elva Jiménez-Hernández, Arturo Fajardo-Gutiérrez, Aurora Medina-Sansón, Janet Flores-Lujano, Laura Eugenia Espinoza-Hernández, David Aldebarán Duarte-Rodríguez, Raquel Amador-Sánchez, José Gabriel Peñaloza-González, José Refugio Torres-Nava, Rosa Martha Espinosa-Elizondo, Luz Victoria Flores-Villegas, Laura Elizabeth Merino-Pasaye, María Luisa Pérez-Saldivar, Elisa María Dorantes-Acosta, Beatriz Cortés-Herrera, Karina Anastacia Solis-Labastida, Nora Nancy Núñez-Villegas, Martha Margarita Velázquez-Aviña, Angélica Rangel-López, Ana Itamar González-Ávila, Jessica Denisse Santillán-Juárez, Alejandra Jimena García-Velázquez, Silvia Jiménez-Morales, Vilma Carolina Bekker-Méndez, Haydee Rosas-Vargas, Minerva Mata-Rocha, Omar Alejandro Sepúlveda-Robles, Jorge Alfonso Martín-Trejo, Juan Manuel Mejía-Aranguré
• Format: Article
• Language: English
• Published: BMC 2019-07-01
• Series: BMC Cancer
• Subjects: Children; Leukemia; Overweight; Obesity; Early mortality; Mexico
• Online Access: http://link.springer.com/article/10.1186/s12885-019-5878-8

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.