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Obesity negatively impacts outcome in elderly female patients with aggressive B-cell lymphomas treated with R-CHOP: results from prospective trials of the German high grade non-Hodgkin's lymphoma trial group.
- Source :
-
British journal of haematology [Br J Haematol] 2018 Jan; Vol. 180 (2), pp. 236-245. Date of Electronic Publication: 2017 Nov 28. - Publication Year :
- 2018
-
Abstract
- To study if obesity is a risk factor in elderly patients (>60 years) with aggressive B-cell lymphoma, the outcomes of 576 elderly patients treated with rituximab in the RICOVER-60 trial were analysed in a retrospective study with regard to body mass index (BMI) and gender. Of the 576 patients, 1% had low body weight (BMI < 18·5), 38% were normal weight (18·5 ≤ BMI < 25), 42% were overweight (25 ≤ BMI < 30) and 19% were obese (BMI ≥ 30). Event-free (EFS), progression-free (PFS) and overall survival (OS) according to BMI showed no significant differences for all and for male patients. EFS (P = 0·041), PFS (P = 0·038) and OS (P = 0·031) were significantly better for female non-obese patients. A multivariate analysis adjusted for International Prognostic Index risk factors confirmed these results, with the following hazard ratios (HR) for obesity (BMI ≥ 30) for EFS/PFS/OS: all patients - 1·4/1·4/1·4 (not significant); male patients - 1·2/1·2/1·0 (not significant) and female patients - 1·7 (P = 0·032)/1·9 (P = 0·022)/2·0 (P = 0·017). In conclusion, obesity is a risk factor that influences treatment outcome in elderly female patients with aggressive B-cell lymphoma treated with R-CHOP (rituximab + cyclophosphamide, doxorubicin, vincristine, prednisolone). The inferior outcomes in obese female patients may be due to faster rituximab clearance in obese females.<br /> (© 2017 John Wiley & Sons Ltd.)
- Subjects :
- Age Factors
Aged
Aged, 80 and over
Antibodies, Monoclonal, Murine-Derived adverse effects
Antibodies, Monoclonal, Murine-Derived therapeutic use
Antineoplastic Combined Chemotherapy Protocols adverse effects
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Body Mass Index
Cyclophosphamide adverse effects
Cyclophosphamide therapeutic use
Disease Progression
Doxorubicin adverse effects
Doxorubicin therapeutic use
Female
Germany
Humans
Lymphoma, B-Cell drug therapy
Lymphoma, B-Cell pathology
Male
Middle Aged
Neoplasm Grading
Neoplasm Staging
Prednisone adverse effects
Prednisone therapeutic use
Rituximab
Sex Factors
Survival Analysis
Treatment Outcome
Vincristine adverse effects
Vincristine therapeutic use
Lymphoma, B-Cell complications
Lymphoma, B-Cell mortality
Obesity complications
Subjects
Details
- Language :
- English
- ISSN :
- 1365-2141
- Volume :
- 180
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- British journal of haematology
- Publication Type :
- Academic Journal
- Accession number :
- 29193018
- Full Text :
- https://doi.org/10.1111/bjh.15029