Impacto de la obesidad en el pronóstico de supervivencia y recaída en niños con leucemia aguda linfoblástica del estado de México

Introduction

In Mexico, childhood cancer and obesity are public health problems. Malnutrition, but not obesity, has been associated with a lower probability of survival and increased risk of relapse.

Objective

To assess the impact of obesity on the prognosis of survival and relapse in children with Acute Lymphoblastic Leukaemia (ALL).

Material and methods

Children with ALL were included in a cohort. An assessment was made of the nutritional status at diagnosis, according to BMI values in children, searching for an association of obesity and other factors with disease relapse and survival using Kaplan-Meier curves and Cox regression.

Results

A total of 161 patients were studied, of which 70% were males with obesity, and of these, 43% had very high risk ALL. Obesity increased the risk for relapse (OR: 3.6; 95% CI: 1.7-7.6, p=.001) and death (OR: 3.4; 95% CI: 1.51-7.48, p=.002), and limited 77-month survival to 52%. An Exp β of 3.35 was obtained in the Cox regression for patients with obesity and a very high risk leukaemia.

Discussion

Obesity influences the prognosis of relapse and survival time, due to a considerable increase in toxicity and some growth factors that induce chemoresistance in neoplastic cells. Biological factors influencing the prognosis of the disease may not be modifiable; however, it is essential to establish health policies aimed at early diagnosis, as well as at obesity and overweight prevention.