Obesity has been reported in several series of adults with acute promyelocytic leukemia (APL) (

Estey et al., Leukemia 11:1661–1664,1997
;
Douer et al.,Blood 87:308–313,1996
). Speculation regarding causation has included an association with female gender and/or an increased incidence of this disease in peoples of Latin extraction (Douer, Blood 1996). To date there have been no published reports of evaluation for obesity in children with APL. We report herein the results of an evaluation of body size of children enrolled on the first North American Intergroup trial of APL (INT 0129)(
Tallman et al., N Engl J Med 337:1021–1028,1997
). This study was open for patient (pt) enrollment from April 1992 to February 1998. Fifty-three children (aged 1.4–18 years) with confirmed t (15;17) APL were eligible and evaluable. Body mass index (BMI) was calculated and compared to normals according to data from the 2000 CDC report (Ogden et al., Pediatrics 109:45–60,2002). Those pts who were obese (BMI > 95th centile for age and gender) were compared to the others on this trial. Three pts were excluded: 2 were too young for BMI assessment (< 2 years of age) and 1 insufficient body size data. Of the 50 evaluable pts, 26% (13/50) were obese. This compares to the expected overall incidence of 11% in the healthy pediatric population (Troiano et al., Pediatrics 101:497–504,1998). Comparisons of the obese pts to the rest on INT 0129 are shown:

Obese compared to non-obese pts

Age (med)SexHispanicCRDFS-10 yr *Survival-10 yr *
*Kaplan-Meier estimates 
Obese (13) 12.7 yrs 54% F 8% 85% 55% 77% 
Not Obese (37) 11.8 yrs 62% F 16% 84% 34% 57% 
Age (med)SexHispanicCRDFS-10 yr *Survival-10 yr *
*Kaplan-Meier estimates 
Obese (13) 12.7 yrs 54% F 8% 85% 55% 77% 
Not Obese (37) 11.8 yrs 62% F 16% 84% 34% 57% 
View Large

There were no statistically significant differences in CR (p>0.99), DFS (p=0.56), or survival (p=0.31) between the obese and the non-obese. Our data confirm a higher than expected incidence of obesity in children with APL, as previously reported in some adult series. Although the number of pts is relatively small, there is no suggestion of an increased representation of females or Hispanics in this subgroup of APL. Also of interest, the outcomes for obese children in this trial were no worse than for the non obese. The association of obesity at diagnosis with APL appears to be a real one, and deserves confirmation via meta-analysis of other pediatric trials, and investigation as to possible causal links with APL.

Topics:
acute promyelocytic leukemia, child, obesity, childhood obesity, brachial plexus neuritis, leukemia

Disclosure: No relevant conflicts of interest to declare.

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Corresponding author

2006, The American Society of Hematology
2006
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