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Chihara D, Larson MC, Robinson DP, Thompson CA, Maurer MJ, Casulo C, Pophali P, Link BK, Habermann TM, Feldman AL, Flowers CR, Cerhan JR, Morton LM. Body mass index and survival of patients with lymphoma. Leuk Lymphoma 2021; 62:2671-2678. [PMID: 34121594 PMCID: PMC8771423 DOI: 10.1080/10428194.2021.1929956] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The impact of body mass index (BMI) on survival in lymphoma remains controversial. We leveraged a prospective cohort of lymphoma patients enrolled to SPORE Molecular Epidemiology Resource between 2002 and 2015 to assess the association of BMI before diagnosis, BMI at diagnosis, and BMI change over time with lymphoma-specific survival (LSS). A total of 4009 lymphoma patients (670 diffuse large B-cell lymphoma (DLBCL), 689 follicular lymphoma (FL), 1018 chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), and 1632 other subtypes) were included. Significantly shorter LSS after diagnosis was observed for FL patients who were obese before diagnosis (HR: 3.02, 95%CI: 1.43-6.41, p=.004) and for those with a ≥ 5% increase in BMI from diagnosis to 3-year follow-up (HR: 3.53, 95%CI: 1.22-10.2, p=.020). In contrast, obesity prior to or at the time of diagnosis was not associated with LSS in DLBCL and CLL/SLL. The impact of weight control after diagnosis in FL patient warrants investigation.
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Affiliation(s)
- Dai Chihara
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX,,Medical Oncology Service, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | | | - Carrie A. Thompson
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | | | - Carla Casulo
- Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY
| | - Priyanka Pophali
- Division of Hematology, Oncology and Palliative Care, Department of Medicine, University of Wisconsin, Madison, WI
| | - Brian K. Link
- Division of Hematology, Oncology, and Blood & Marrow Transplantation, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Thomas M. Habermann
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - Andrew L. Feldman
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Christopher R. Flowers
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - James R. Cerhan
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Lindsay M. Morton
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
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Bouleftour W, Mery B, Chanal E, Rowinski E, Viard A, Forges F, Fournel P, Rivoirard R. Obesity and chemotherapy administration: between empiric and mathematic method review. Acta Oncol 2019; 58:880-887. [PMID: 30907190 DOI: 10.1080/0284186x.2019.1585942] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Obesity is a major risk factor for chronic disease and cancer development. Therapeutic management of obese patients with cancer is a real challenge for physician because of the alteration of antineoplastic pharmacokinetics parameters in this population. In routine clinical practices, chemotherapy doses in obese patients are arbitrarily capped or adjusted to an ideal weight to minimize excessive toxicities. Material and methods: The main goal of this review is to describe the current state of knowledge concerning the correlation between the adjustment of BSA (capping or ideal weight) and the rates of global toxicities and survival outcomes in obese patients under chemotherapy in different types of cancer. We searched in the Medline database (via PubMed) in order to identify all publications of literature reviews whose subject chemotherapy dosing in obese population. Results: Only a single study was pointing toward increased of global toxicities of full weight dosing. Furthermore, some studies suggests that the practice of limiting doses in overweight and obese patients may negatively influence the quality of care and outcomes in a constantly increasing population. Conclusion: This review highlights the lack of prospective studies focusing on chemotherapy methods of administration in obese patients. At this time, there is no prospective study comparing capping and full weight dose chemotherapy administration in obese patient population.
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Affiliation(s)
- W. Bouleftour
- Département d’oncologie médicale, Institut de cancérologie Lucien Newirth, Saint Priest en Jarez, France
| | - B. Mery
- Département d’oncologie médicale, Institut de cancérologie Lucien Newirth, Saint Priest en Jarez, France
| | - E. Chanal
- Département d’oncologie médicale, Institut de cancérologie Lucien Newirth, Saint Priest en Jarez, France
| | - E. Rowinski
- Département d’oncologie médicale, Institut de cancérologie Lucien Newirth, Saint Priest en Jarez, France
| | - A. Viard
- Département d’oncologie médicale, Institut de cancérologie Lucien Newirth, Saint Priest en Jarez, France
| | - F. Forges
- Département d’oncologie médicale, Institut de cancérologie Lucien Newirth, Saint Priest en Jarez, France
| | - P. Fournel
- Département d’oncologie médicale, Institut de cancérologie Lucien Newirth, Saint Priest en Jarez, France
| | - R. Rivoirard
- Département d’oncologie médicale, Institut de cancérologie Lucien Newirth, Saint Priest en Jarez, France
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