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- Title
Prevalence of Hyperglycemia and Obesity in Patients (pts) with Newly Diagnosed Acute Lymphoblastic Leukemia (ALL).
- Authors
Vu, Khanh D.; Strom, Sara; Konopleva, Marina; Thomas, Deborah A.; Faderl, Stefan H.; Hubbard, Julie C.; Andreeff, Michael; Kantarjian, Hagop; Lavis, Victor R.
- Abstract
Increasing evidence suggests associations between obesity, diabetes and/or hyperglycemia (DM/HG) and prevalence and outcome of pts with solid tumors. Less is known about these metabolic factors and hematologic malignancies. To determine the prevalence of DM/HG and obesity in pts with acute leukemia and whether these are predictors of response and survival, we conducted a retrospective chart review of 299 pts with newly diagnosed ALL. All pts were evaluated at our institution between November 1999 and May 2005 and received a uniform ALL induction. Median age was 43 yrs (range 15-83). Prevalence of DM/HG (hyperglycemia defined by glucose ≥200 mg/dL) at diagnosis and prior to therapy was 16%. Prevalence was identical by gender, but increased with age (2% in <40 yrs, 17% in 40-59 yrs, and 21% in ≥60 yrs). Pts with DM/HG were significantly older than those without DM/HG (median age 57 yrs vs. 40 yrs, p<0.001). Prevalence of diabetes, by age and gender, was higher in pts with ALL when compared to the diabetes prevalence of the general population based on the NHANES data (1999-2002). The prevalence of obesity (BMI>30kg/m²) in pts with ALL was lower when compared to the obesity prevalence of the general population, 28% vs. 55%, respectively. Complete remission (CR) rate was similar in the DM/HG group vs. non-DM/HG group, as well as between obese and non-obese pts. In univariate analysis, DM/HG, obesity, and older age were associated with shorter overall survival (OS). Mean OS of pts with DM/HG was 134 vs. 194 wks for pts without DM/HG, (p<0.02). Mean OS of obese pts was 136 vs. 199 wks for non-obese pts, (p<0.01). However, in a multivariable Cox regression model, the only factors that remained significantly associated with survival were age, obesity, and white blood cell count. The prevalence data suggest that DM/HG is a risk factor for development of ALL. The association of obesity with shorter OS warrants further investigation.
- Publication
Diabetes, 2007, Vol 56, pA274
- ISSN
0012-1797
- Publication type
Academic Journal