Table 3.

Meta-Analyses of Relapse Risk with Obesity in ALL Patients.

Author	Study Design	Population	Protocol	Findings
Saenz et al. [57]	RCS + Meta-analysis	n = 181 Age: 2–17 years	COG	A trend of relapse risk for obese/overweight patients (HR 2.89, 95% CI 0.89–9.36, p = 0.08) in age-and sex-adjusted patients ≥ 10 years old. While meta-analyses reported increased mortality in the overweight/obese group (HR 1.39, 95% CI 1.16–1.46, p < 0.05), this was not confirmed in adjusted analyses
Orgel et al. [58]	Meta-analysis	11 articles n = 8680 (ALL), Age: 0–21 years	Included all treatment regimens that reported the effect of weight on treatment outcomes, specifically EFS mortality, overall survival, the cumulative incidence of relapse, and treatment-related toxicity	When compared to a lower BMI, higher BMI was associated with a statistically nonsignificant trend of risk of relapse (RR 1.17; 95% CI: 0.99, 1.38) Patients with a higher BMI had lower EFS (RR 1.35, 95% CI 1.20, 1.51) than those with lower BMI

Abbreviations: RCS, retrospective cohort study; COG, Children’s Oncology Group; HR, hazard ratio; CI, confidence interval; ALL, Acute Lymphoblastic Leukemia; EFS, event-free survival; RR, risk ratio; BMI, body mass index.