Clinical Analysis On The Relationship Between Body Mass Index And Newly Diagnosed Adult Patients With Acute Myeloid Leukemia

Objective:To analysis the relationship between different BMI(body mass index)groups and clinical characteristics,laboratory examination indexes of newly diagnosed adult patients with acute myeloid leukemia(AML),and their effects during the first induction chemotherapy.Methods:From August 2015 to August 2019,there were 145 newly diagnosed adult patients with AML(patients with acute promyelocytic leukemia were excluded)in the First Hospital of Lanzhou University.Retrospective analysis data about clinical characteristics such as BMI before induction chemotherapy,and gender,age,risk Stratification,leukemia type,gene mutation,comorbidities,length of hospital day,and other laboratory indexes such as WBC,Hb,albumin,triglyceride(TG),total cholesterol(TC),high density lipoprotein(HDL),low density lipoprotein(LDL),lactic dehydrogenase(LDH).And collecting data about chemotherapy related adverse such as febrile neutropenia,documented infection,agranulocytosis duration,bleeding,liver and kidney toxicity,and morphology remission of patients.The patients were divided into three groups according to their BMI before induction chemotherapy:underweight group(BMI<18.5 kg/m~2,normal weight group(18.5 kg/m~2?BMI?23.9 kg/m~2),overweight and obese group(BMI?24 kg/m~2).Results:1.The 145 newly diagnosed adult patients with AML included 71 males and 74 females.The median age was 50 years(range 18 to 82 years).There were 21 in underweight group(14.5%),79 in normal weight group(54.5%),and 45 were in overweight and obese group(31.0%).2.The average age of the underweight group was(42.4±15.4)years,normal weight group was(49.1±15.1)years,and overweight and obese group was(52.8±9.7)years(P=0.018).The higher the BMI level,the older the age.There were 57.1%were male(n=12)and 42.9%were female(n=9)in the underweight group,39.2%were male and60.8%were female(n=48)in the normal body weight group(n=31),and 62.2%were male(n=28)and 37.8%were female(n=17)in the overweight and obese group.We found significant differences in gender between the groups(P=0.035).The number of male was significantly more than female in overweight and obese patients.3.There were no statistical differences in AML classification,comorbidities,and length of hospital day,whether secondary AML,FLT3 gene mutation,and risk stratification among different BMI groups.4.We found significant differences in TG,with overweight and obese patients being higher(P=0.007),but no significant differences in WBC and Hb counts,albumin,TC,HDL,LDL,or LDH between BMI groups at newly diagnosed.5.The complete remission rate in the underweight groups(38.1%,P=0.080)or overweight and obese groups(37.8%,P=0.020)was lower than that in the normal body weight group(59.5%),which was statistically significant(P=0.035).There were not significant differences between groups for the induction chemotherapy and the number of chemotherapy until complete remission(CR).Multivariate analysis showed that overweight and obese(P=0.012)and FLT3 mutation(P=0.015)were risk factors affecting the CR rate.And patients with secondary AML,high-risk type,and newly diagnosed WBC?50×10~9/L had lower CR rate,but there was no statistical difference among three groups.6.The rate of documented infection during the first induction chemotherapy groups were significantly higher in underweight group(61.9%)than that in normal weight group(36.7%,P=0.038)or overweight and obese group(28.9%,P=0.011),and there were significantly different(P=0.038).We found febrile neutropenia(90.5%),bleeding(19%)and the time of neutropenia longer than the others in the underweight group,but it was not statistically significant.There was no statistical difference in liver and kidney toxicity among three groups.Conclusion:1.The higher the level of BMI in newly diagnosed adult AML patients,the older they are.The number of males was significantly more than females in overweight and obese patients.2.Overweight and obese patients have higher TG level,and BMI groups were no associated with AML classification,comorbidities,length of hospital stay,secondary AML,FLT3 gene mutation,risk stratification,and WBC counts,Hb level,albumin,TC,HDL,LDL,LDH in newly diagnosed.3.Underweight,overweight or obesity,and FLT3 mutation will reduce the early efficacy of AML patients,and the underweight group has more adverse events during induction chemotherapy.4.Abnormal BMI level can be defined as a risk factor for assessing the prognosis of newly diagnosed adult patients with AML.