Obese non-Hodgkin lymphoma patients tolerate full uncapped doses of chemotherapy with no increase in toxicity, and a similar survival to that seen in nonobese patients

Henry Chan; Sharon Jackson; Jessica McLay; Angela Knox; Jae Lee; Sarah Wang; Samar Issa

doi:10.3109/10428194.2016.1151508

Obese non-Hodgkin lymphoma patients tolerate full uncapped doses of chemotherapy with no increase in toxicity, and a similar survival to that seen in nonobese patients

Leuk Lymphoma. 2016 Nov;57(11):2584-92. doi: 10.3109/10428194.2016.1151508. Epub 2016 Mar 4.

Authors

Henry Chan¹, Sharon Jackson¹, Jessica McLay², Angela Knox¹, Jae Lee¹, Sarah Wang¹, Samar Issa¹

Affiliations

¹ a Department of Haematology , Middlemore Hospital , Auckland , New Zealand ;
² b Department of Statistics , University of Auckland , Auckland , New Zealand.

PMID: 26943235
DOI: 10.3109/10428194.2016.1151508

Abstract

The aim of this study is to compare the risk of treatment-related toxicities and long-term survival between obese and nonobese patients with non-Hodgkin lymphoma when treated with full uncapped doses of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy. A total of 133 patients and 733 cycles of chemotherapy were analyzed. Obese patients did not experience an increased risk of acute treatment-related toxicities (adjusted odds ratio 0.825, p = 0.197), or delayed toxicities (adjusted odds ratio 0.819, p = 0.779). In the subgroup of diffuse large B-cell lymphoma patients (n = 109), treatment response rate was similar between the two body mass index (BMI) groups, and obese patients tended to have superior overall and progression-free survivals, albeit not statistically significant. Full uncapped doses of R-CHOP chemotherapy administered to obese patients with non-Hodgkin lymphoma (NHL) are safe, well tolerated, and do not lead to inferior treatment response or long-term outcomes.

Keywords: Chemotherapy; non-Hodgkin lymphoma; obesity.

MeSH terms

Adult
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
Cyclophosphamide / adverse effects
Cyclophosphamide / therapeutic use
Doxorubicin / adverse effects
Doxorubicin / therapeutic use
Drug Tolerance*
Drug-Related Side Effects and Adverse Reactions / diagnosis*
Drug-Related Side Effects and Adverse Reactions / etiology*
Female
Follow-Up Studies
Humans
Lymphoma, Non-Hodgkin / complications*
Lymphoma, Non-Hodgkin / diagnosis
Lymphoma, Non-Hodgkin / drug therapy*
Lymphoma, Non-Hodgkin / mortality
Male
Middle Aged
Neoplasm Staging
Obesity / complications*
Obesity / diagnosis
Prednisone / adverse effects
Prednisone / therapeutic use
Prognosis
Rituximab
Treatment Outcome
Vincristine / adverse effects
Vincristine / therapeutic use
Young Adult

Substances

Antibodies, Monoclonal, Murine-Derived
R-CHOP protocol
Rituximab
Vincristine
Doxorubicin
Cyclophosphamide
Prednisone