Obesity's Impact on Prognosis in Ph‐Like Acute Lymphoblastic Leukemia

ABSTRACT Obesity is associated with chemotherapy resistance and poorer survival in pediatric high‐risk B‐lymphoblastic leukemia (B‐ALL). Philadelphia‐like (Ph‐like) B‐ALL is a high‐risk subset associated with poor outcomes. Our prior work linked CRLF2‐overexpressed Ph‐like B‐ALL with obesity. However, the prognostic impact of obesity in Ph‐like B‐ALL has not been defined. Patients with end‐of‐induction measurable residual disease (EOI MRD)‐positivity did poorly regardless of obesity status; however, among patients with EOI MRD‐negativity, obesity was associated with inferior event‐free survival (EFS) (3‐year EFS 59% vs. 100%, p = 0.014). These data support obesity as a poor prognostic factor in Ph‐like B‐ALL, even among patients achieving early remission.