How Obesity Affects ALL Patients’ Chances of Survival

 

Dr. Steven Mittelman, Ph.D. presented a wealth of knowledge to clarify the link between obesity and cancer, specializing in leukemia, and suggested there could also be a spread of opportunities for intervention to enhance survival.

A landmark study by Calle et al2 found that obesity is accountable for over 90,000 cancer deaths p.a. within the U.S., and in line with the American Institute for Cancer Research (AICR), over 100,000 cancers annually are linked to excess body fat, said Dr. Mittelman, who is Director of the Diabetes and Obesity Program at Children’s Hospital L.A. and professor of Pediatrics and Physiology & Biophysics at Keck School of Medication, University of Southern California, L.A.

Obesity has been shown to extend cancer incidence, and obese cancer patients experience worse outcomes than lean patients. Retrospective studies have confirmed that children who were obese at the time of diagnosis of high-risk acute lymphocytic leukemia (ALL) have a significantly higher risk of relapse than their leaner counterparts. This leads to the importance of losing weight, which Exipure is all about. You can also read Exipure customer reviews to get more information about this product.

Underlying Mechanisms

“Obesity isn’t an easy phenotype,” said Dr. Mittelman. Hence, the sheer number of associations and internal and external factors related to obesity makes it difficult to elucidate mechanisms in humans, stressing the necessity for animal models.

Using mouse models, obesity accelerates the onset of spontaneous leukemia is what Dr. Mittelman and colleagues found. Additionally, obese mice implanted with leukemia cells experienced poorer survival after being treated with either vincristine or asparaginase (Elspar), and adipocytes gave the impression to be at the basis of this worse outcome.

To migrate closer to fat cells, Adipocytes attract ALL cells. The fat cells absorb the chemotherapy, making the treatment unable to succeed in the ALL cells and fewer available within the leukemia microenvironment. Allowing them to proliferate and avoid apoptosis, Adipocytes also secrete asparagine, glutamine, fatty acids, and other fuels that help leukemia cells survive. “We think fat cells can be protecting nearby leukemia cells from oxidative stress as it can be a part of how they’re protecting them from chemotherapies,” he ­explained.

Ultimately, adipocytes may contribute to a poorer prognosis in obese patients with ALL and impair their leukemia-related survival is what Dr. Mittelman and colleagues concluded. This can be cause for particular concern, considering the high prevalence of overweight and obese pediatric cancer patients, particularly among those with leukemia, suggested Dr. Mittelman.

 

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Childhood Obesity and Leukemia

About one-third of youngsters within the U.S. are overweight or obese. To further compound this problem, cancer treatment typically results in weight gain. “High-risk ALL patients experience a large and cumulative burden of fat, which can likely hinder their leukemia treatment and lessen their chances of survival.

Opportunities for Intervention

Evidence suggests that the implications of obesity could also be reversible. A recently published retrospective analysis3 cited by Etan Orgel, MD, also from Children’s Hospital L.A., found that those that were obese at diagnosis but lost weight and have become nonobese for quite half the duration of their treatment experienced better outcomes, such as their counterparts who were never overweight or obese.

“This implies that the effect of obesity to impair survival isn’t fixed at diagnosis,” suggested Dr. Mittelman. “If we were to intervene to do to enhance leukemia outcome, at the identical time, we might likely (or hopefully) be improving a number of these long-term ­complications.”

In additional laboratory experiments, Dr. Mittelman and his colleagues also found that switching obese mice to a diet at the onset of ALL treatment greatly improved their survival, giving them better outcomes than the control mice who had been raised there on the same diet. “To determine if we are able to reduce their obesity, slow their gain in body fat, and perhaps even improve their survival considering these data, staring at the clinical outcomes, viewing the mouse data, and knowing what we all know about adipose tissue-protecting leukemia cells, I believe that some interventions in kids would definitely be justified,” he suggested.