Modelling The Influence Of Diet On APL Identifies Insulin-Growth Factor 1 As A Central Mediator and Provides A Mechanistic Rationale For Therapeutic Weight Loss

We (Breccia et al, Blood 2012) recently reported that risk and prognosis of Acute Promyelocytic Leukemia (APL) is strongly affected by an elevated body mass index (BMI). In our cohort, overweight/obese patients had a 3-fold higher cumulative incidence of relapse at 5 years (31,6% vs 11.2%, p=0.029) and BMI was found to be an independent prognostic factor at multivariate analysis. As the prevalence of overweight/obesity increases in the Western world, it becomes imperative to understand which molecular mechanisms mediate the interaction between systemic metabolism and APL, and cancer in general. Importantly, it remains to be proven that dietary interventions aimed at weight loss can provide any clinical benefit for cancer patients. Mouse models of leukemia provide a tractable system to address such questions experimentally.