接受AIDA方案治疗的急性早幼粒细胞性白血病患者的BMI增加与疾病复发和分化综合征风险增加有关

We investigated whether body mass index (BMI) correlates with distinct outcomes in newly diagnosed acute promyelocytic leukemia (APL). The study population included 144 patients with newly diagnosed and genetically confirmed APL consecutively treated at a single institution. All patients received All-trans retinoic acid and idarubicin according to the GIMEMA protocols AIDA-0493 and AIDA-2000. Outcome estimates according to the BMI were carried out together with multivariable analysis for the risk of relapse and differentiation syndrome. Fifty-four (37.5%) were under/normal weight (BMI<25), whereas 90 (62.5%) patients were overweight/obese (BMI≥25). An increased BMI was associated with older age (P<.0001) and male sex (P=.02). BMI was the most powerful predictor of differentiation syndrome in multivariable analysis (odds ratio=7.24; 95% CI, 1.50-34; P=.014). After a median follow-up of 6years, the estimated cumulative incidence of relapse at 5years was 31.6% (95% CI, 22.7%-43.8%) in overweight/obese and 11.2% (95% CI, 5.3%-23.8%) in underweight/normal weight patients (P=.029). Multivariable analysis showed that BMI was an independent predictor of relapse (hazard ratio=2.45, 95% CI, 1.00-5.99, in overweight/obese vs under/normal weight patients, P=.049). An increased BMI at diagnosis is associated with a higher risk of developing differentiation syndrome and disease relapse in APL patients treated with AIDA protocols.