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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
Author(s) -
Hohloch K.,
Altmann B.,
Pfreundschuh M.,
Loeffler M.,
Schmitz N.,
Zettl F.,
Ziepert M.,
Trümper L.
Publication year - 2018
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.15029
Subject(s) - medicine , rituximab , international prognostic index , vincristine , body mass index , hazard ratio , overweight , lymphoma , diffuse large b cell lymphoma , cyclophosphamide , chop , gastroenterology , oncology , chemotherapy , confidence interval
Summary 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.