CHICAGO – Research presented at the American Society of Clinical Oncology (ASCO) 2025 annual meeting suggests that a high body mass index (BMI) is associated with poorer outcomes in adult patients with acute lymphoblastic leukemia (ALL). The studies investigated the correlation between BMI and the effectiveness of treatments, as well as the broader global impact of high BMI on ALL-related disability and mortality.

Inotuzumab Ozogamicin Efficacy and BMI

One study focused on the efficacy of inotuzumab ozogamicin (InO), a drug approved for relapsed or refractory B-cell precursor ALL, in patients with different BMI categories. Researchers, including W. Stock,R. Cassaday, and D. DeAngelo, analyzed data from 338 patients across multiple clinical trials to assess how BMI affects treatment outcomes.

Patients where categorized into three groups based on their BMI: healthy (less than 25 kg/m²), overweight (25-30 kg/m²), and obese (greater than 30 kg/m²). The study revealed that while the rates of complete remission were similar across all BMI groups, survival probabilities were notably lower in patients with higher BMIs.

Specifically, at 24 months:

• Progression-free survival was 19.9% for the healthy BMI group, 12.8% for the overweight group, and 10.9% for the obese group.
• Overall survival was 28.1% for the healthy BMI group, 22.1% for the overweight group, and 17.5% for the obese group.

The incidence of adverse events and the proportion of patients proceeding to hematopoietic stem cell transplantation (HSCT) were consistent across the groups. Though,the researchers concluded that elevated BMI is correlated with diminished progression-free and overall survival rates in ALL patients treated with InO.

“This study demonstrates the escalating burden of high BMI as a risk factor for ALL.”

Global Trends: BMI, DALYs, and ALL

A separate study examined global trends in ALL-related disability-adjusted life years (DALYs) and deaths attributable to high BMI from 1990 to 2021. Researchers A. Dixit, S. Sahu, and S. Iftikhar, utilizing data from the Global Burden of Diseases database, found that while dalys have steadily increased, deaths have remained relatively stable with only a slight increase over the 30-year period.

The age-standardized mortality ratio also showed a gradual increase. The researchers emphasized the strong correlation between DALYs and deaths, noting that the growing DALY burden indicates increased non-fatal impairments and years of life lost due to disability among ALL patients.

The researchers concluded that the rising burden of high BMI as a risk factor for ALL is primarily driven by an increase in DALYs, underscoring the need for targeted interventions, preventative measures, and improved management strategies.