For pediatric patients with acute lymphoblastic leukemia (ALL), obesity increases risk of persistent disease

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According to a new study published in the journal Blood, obese pediatric patients with acute lymphoblastic leukemia (ALL) are more likely to have minimal residual disease following induction therapy compared with non-obese patients.

Researchers at Childrens Hospital Los Angeles in Los Angeles, California, sought to determine why obese pediatric patients with ALL have worse outcomes compared with non-obese patients. For the study, the team identified 189 pediatric patients diagnosed with ALL. Patients were considered lean if they were classified as being less than 85% body mass index (BMI). Nearly one-third of patients were overweight or obese at the time of initial diagnosis.

To test for minimal residual disease, researchers tested the bone marrow of patients following induction therapy for 2 to 5 years from the time of diagnosis. Results showed that lean patients with minimal residual disease experiences comparable outcomes to obese patients with no evidence of residual disease.

In addition, obese patients with residual disease were observed to have the worst outcomes. Patients that were lean at the time of diagnosis but became obese during the first month of treatment had similar outcomes to patients who remained lean throughout treatment. The findings suggest that obesity increases the risk of persistent disease and alters the interaction between residual ALL cells and chemotherapy.

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Obese pediatric patients with ALL are more likely to have minimal residual disease.

Obese youths with acute lymphoblastic leukemia (ALL) are known to have worse outcomes than their lean counterparts. To find out why, investigators at Children's Hospital Los Angeles studied patients who were obese at the time of their diagnosis with ALL to determine if body mass index (BMI) impacted response to initial chemotherapy. This response to initial chemotherapy (or induction therapy) is measured by the absence of leukemia cells in the bone marrow.

Called minimal residual disease (MRD), in which residual leukemia cells cannot be seen under microscope but can be detected by more sensitive methods, it is among the strongest predictors of long-term survival and disease recurrence. As reported in First Edition of the journal Blood on October 27, following induction chemotherapy, obese patients were more than twice as likely to have minimal residual disease, than non-obese patients.

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