Body mass index as a prognostic factor in Asian patients treated with chemoimmunotherapy for diffuse large B cell lymphoma, not otherwise specified

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• 作者：Hee Sang Hwang ; Dok Hyun Yoon ; Cheolwon Suh ; Jooryung Huh
• 关键词：Obesity ; Body mass index ; Diffuse large B cell lymphoma ; Asians
• 刊名：Annals of Hematology
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：94
• 期：10
• 页码：1655-1665
• 全文大小：1,060 KB
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• 作者单位：Hee Sang Hwang (1)
  Dok Hyun Yoon (2)
  Cheolwon Suh (2)
  Jooryung Huh (1)
  
  1. Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Seoul, 138-736, Korea
  2. Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Hematology
  Oncology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0584

文摘

Obesity was recently reported to confer a survival advantage in diffuse large B cell lymphoma (DLBCL) among Western populations. Given ethnic differences, previous studies recommended a revision of the WHO classification of obesity for Asians. We investigated the prognostic impact of body mass index (BMI) using modified WHO criteria in a retrospective cohort of 562 Korean patients with DLBCL. Patients were categorized into five groups according to BMI: 26 (4.6 %) as underweight (<18.5 kg/m2), 230 (40.9 %) as normal weight (18.5-2.9 kg/m2), 129 (23.0 %) as overweight (23.0-4.9 kg/m2), 160 (28.5 %) as obese (25.0-9.9 kg/m2), and 17 (3.0 %) as severely obese (?0 kg/m2). As BMI increased, the relative hazard ratio (HR) decreased sharply, reaching the lowest value in the overweight group, and then rose again in the obese and severely obese. On univariate analysis, both overall survival (OS) and progression-free survival (PFS) were best in the overweight group, followed by normal-gt;?obese-gt;?severely obese-gt;?underweight groups. Multivariate analysis showed a significantly shorter survival in the underweight (OS: HR 2.90, 95 % confidence interval (CI) 1.35-.19, P--.006; PFS: HR 3.08, 95 % CI 1.55-.09, P--.001) and severely obese groups (OS: HR 2.93, 95 % CI 1.08-.95, P--.035; PFS: HR 2.59, 95 % CI 1.06-.36, P--.038). We show that being underweight or, contrary to findings in Western patients, being severely obese has a deleterious prognostic impact in DLBCL in Koreans. Revising the BMI criterion that defines obesity according to the patient’s ethnic differences could therefore better delineate DLBCL risk groups in Asian patients. Keywords Obesity Body mass index Diffuse large B cell lymphoma Asians