Association Between Bariatric Surgery and Outcomes in Chronic Myeloid Leukemia

Authors

Fadi G Haddad
Hagop M Kantarjian
Aram Bidikian
Elias J Jabbour
Nicholas J Short
Jing Ning
Lianchun Xiao
Naveen Pemmaraju
Courtney D DiNardo
Tapan M Kadia
Kayleigh R Marx
Guillermo Garcia-Manero
Farhad Ravandi
Koji Sasaki
Ghayas C Issa

Publication Date

6-15-2023

Journal

Cancer

DOI

10.1002/cncr.34725

PMID

36882573

PubMedCentral® Posted Date

6-15-2023

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Bariatric surgery is the most effective weight loss intervention. However, it can also decrease the bioavailability of oral medications. Tyrosine kinase inhibitors, the mainstay treatment for chronic myeloid leukemia (CML), are the most successful example of an oral targeted therapy. The impact of bariatric surgery on CML outcomes is unknown.

Methods: In a retrospective analysis, we screened 652 patients with CML and identified 22 with prior bariatric surgery, and compared their outcomes to a matched cohort of 44 patients with no prior bariatric surgery.

Results: The rate of early molecular response (3-month BCR::ABL1 < 10% International Scale) was lower in the bariatric surgery group compared with the control group (68% vs. 91%; p = .05), with longer median times to achieve complete cytogenetic (6 vs. 3 months; p = .001) or major molecular responses (12 vs. 6 months; p = .001). Bariatric surgery was associated with inferior event-free survival (5-year, 60% vs. 77%; p = .004) and failure-free survival (5-year, 32% vs. 63%; p < .0001). In a multivariate analysis, bariatric surgery was the only independent predictor for the risk of treatment failure (hazard ratio, 9.40; 95% CI, 2.71-32.55; p = .0004) or event-free survival (hazard ratio, 4.24; 95% CI, 1.67-12.23; p = .008).

Conclusions: Bariatric surgery is associated with suboptimal responses that require adapted treatment strategies.

Keywords

Humans, Treatment Outcome, Prognosis, Retrospective Studies, Protein Kinase Inhibitors, Leukemia, Myelogenous, Chronic, BCR-ABL Positive, Fusion Proteins, bcr-abl, bariatric surgery, chronic myeloid leukemia, obesity, response, survival, tyrosine kinase inhibitors

Published Open-Access

yes

Recommended Citation

Haddad, Fadi G; Kantarjian, Hagop M; Bidikian, Aram; et al., "Association Between Bariatric Surgery and Outcomes in Chronic Myeloid Leukemia" (2023). Faculty, Staff and Student Publications. 4912.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/4912