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Ther Adv Hematol. 2011 Jun;2(3):141-5. doi: 10.1177/2040620711408490.

High Prevalence of Obesity in Acute Promyelocytic Leukemia (APL): Implications for Differentiating Agents in APL and Metabolic Syndrome.

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Department of Pathology, Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, TN, USA.



Between January 1999 and December 2008, 469 patients treated for acute myeloid leukemia (AML) were included in this single-institution study.


We performed a case-control analysis to study the rate of obesity among patients with acute promyelocytic leukemia (APL) and non-APL AML.


A total of 81% of APL patients analyzed were obese compared with 41.7% in the non-APL group (p < 0.001). Body mass index (BMI) >30 was seen in 57% of APL patients compared with 31% for the non-APL group (p = 0.01). Neither obesity nor the chemotherapy dosing based on ideal body weight affected survival.


Our findings generate the hypothesis that APL and metabolic syndromes may share a common pathogenic pathway via retinoic acid receptors (RARs), the ligand-controlled transcription factors that function as heterodimers with retinoid X receptors (RXRs) to regulate cell growth and survival. If this link is confirmed in larger studies, our data will instigate further studies using RXR and RAR modulators as a preventive strategy among obese individuals.


RAR; RXR; acute promyelocytic leukemia; body mass index; obesity; prevention

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