Improved survival in overweight and obese patients with aggressive B-cell lymphoma treated with rituximab-containing chemotherapy for curative intent

Leuk Lymphoma. 2019 Jun;60(6):1399-1408. doi: 10.1080/10428194.2018.1538509. Epub 2018 Dec 5.

Abstract

The association between obesity and survival in non-Hodgkin lymphoma is unclear. Using the Ontario Cancer Registry we conducted a retrospective analysis of incident cases of aggressive-histology B-cell lymphoma treated with a rituximab-containing regimen with curative intent between 2008-2016. 6246 patients were included. On multivariable analysis the rate of all-cause mortality was lower for the overweight body mass index (BMI 25-29.9 kg/m2) (HR 0.85; 95%CI 0.77-0.95) and obese BMI (≥30 kg/m2) (HR 0.75; 95%CI 0.67-0.85) groups compared to the normal weight group (18.5-24.9 kg/m2). Binomial logistic regression analysis revealed a lower odds ratio (OR) of admission to hospital during treatment in the overweight (OR 0.84; 95%CI 0.75-0.95) compared to normal weight BMI group. In the largest cohort to date of aggressive-histology B-cell lymphoma patients treated with rituximab, increased BMI is associated with a survival advantage, and the magnitude of this effect increases from overweight to obese BMI.

Keywords: B-cell lymphoma; Obesity; body mass index; rituximab; survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Body Mass Index
  • Comorbidity
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Hospitalization / statistics & numerical data
  • Humans
  • Kaplan-Meier Estimate
  • Lymphoma, B-Cell / drug therapy
  • Lymphoma, B-Cell / mortality*
  • Male
  • Middle Aged
  • Obesity / epidemiology*
  • Ontario / epidemiology
  • Overweight / epidemiology*
  • Progression-Free Survival
  • Registries / statistics & numerical data
  • Retrospective Studies
  • Rituximab / therapeutic use*

Substances

  • Rituximab