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Obesity and the risk of chronic myelogenous leukemia: is this another example of the neoplastic effects of increased body fat?

Leukemia volume 26, pages 183–184 (2012)Cite this article

The risk of cancers of varied tissues is increased in persons who are overweight or obese.1, 2, 3, 4 The increased relative risk (RR) of cancer in overweight and obese subjects has also included the hematological malignancies, although the major types of leukemia and lymphoma have not been stratified in several of these large epidemiological studies.1, 2, 5, 6, 7 Myeloma also has been associated with overweight and obesity as has its antecedent, essential monoclonal gammopathy.8, 9 The evidence for an increased risk of leukemia in the aggregate1, 2, 5, 6, 7 and of the four major types of leukemia is noteworthy.10 Given the broad range of tissues for which a risk of neoplasia is increased in overweight and obese persons, there appears to be a global effect of the metabolic, endocrinologic and inflammatory changes resulting from obesity on either the induction of neoplastic clones, or the selection and enhanced growth and survival of preexisting, dormant transformed clones.

BCR-ABL-positive chronic myelogenous leukemia is a very uncommon secondary leukemia. Unlike secondary acute myelogenous leukemia, which can occur as a result of exposure to high-dose ionizing radiation, certain types of chemotherapy (especially, alkylating agents and topoisomerase inhibitors), prolonged inhalation of tobacco smoke or higher-dose prolonged exposure to benzene, only ionizing radiation is an established cause of secondary chronic myelogenous leukemia.11 In addition, there is little evidence that either a familial predisposition gene (non-syndromic) or an inherited predisposing disorder (syndromic predisposition gene) is associated with chronic myelogenous leukemia, as it is with acute myelogenous leukemia.11 Although a proportion of the healthy population carries low copy numbers of the BCR-ABL oncogene in its blood cells, it is not known whether these clones are susceptible to clonal evolution to a clinically overt neoplasm, either spontaneously or under provocation. The apparent effect of increased fat mass on an increased RR of chronic myelogenous leukemia should be of research interest to students of carcinogenesis and leukemogenesis. The relationship of overweight to cancer is a major challenge to the practice of preventive medicine and the soft (cajoling) and hard (pharmacotherapy) science of behavior modification.

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  1. Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA

    M A Lichtman

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Correspondence to M A Lichtman.

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The author has served as a medical expert for the defense in toxic tort cases and, in that context, has relied on research studies of obesity as a risk factor for the development of a hematological malignancy.

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Lichtman, M. Obesity and the risk of chronic myelogenous leukemia: is this another example of the neoplastic effects of increased body fat?. Leukemia 26, 183–184 (2012). https://doi.org/10.1038/leu.2011.190

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