Obesity is associated with an impaired survival in lymphoma patients undergoing autologous stem cell transplantation


Autoři: Sebastian Scheich aff001;  Julius C. Enßle aff001;  Victoria T. Mücke aff002;  Fabian Acker aff001;  Lukas Aspacher aff001;  Sebastian Wolf aff001;  Anne C. Wilke aff001;  Sarah Weber aff001;  Uta Brunnberg aff001;  Hubert Serve aff001;  Björn Steffen aff001
Působiště autorů: Department of Hematology and Oncology, University Hospital Frankfurt, Frankfurt am Main, Germany aff001;  Department of Gastroenterology, Hepatology, Pulmonology and Endocrinology, University Hospital Frankfurt, Frankfurt am Main, Germany aff002
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225035

Souhrn

Autologous hematopoietic stem cell transplantation (auto-HSCT) provides a potentially curative treatment option for relapsed and refractory lymphomas. Obesity displays an emerging epidemic risk factor for global mortality and is associated with an increased mortality in cancer patients. To date, the impact of obesity on the outcome of lymphoma patients undergoing auto-HSCT is understudied. We conducted a retrospective single-center study assessing 119 lymphoma patients who underwent auto-HSCT. Overall survival (OS) served as the primary endpoint whereas progression free survival (PFS), cumulative incidence of non-relapse related mortality (NRM) and cumulative incidence of relapse were analyzed as secondary endpoints. Obese patients (Body mass index, BMI≥30) had significantly lower OS (45.3% vs. 77.9%; p = 0.005) and PFS (29.8% vs. 67.2%; p<0.001) compared to non-obese patients at 48 months post-transplantation. The cumulative incidence of NRM displayed no significant differences while the cumulative incidence of relapse was significantly increased in patients with BMI≥30 (66.2% vs. 21.5%; p<0.001). Patients with a BMI<25 and overweight patients (BMI 25–30; 76.1% vs. 80.9%; p = 0.585), showed no significant difference in OS, whereas patients with BMI≥30 exhibited significant lower OS when compared to either of both groups (76.1% vs. 45.3%; p = .0.021 and 80.9% vs. 45.3%; p = 0.010). Furthermore, in a multivariate analysis, obesity was identified as an independent risk factor for death (Hazard ratio 2.231; 95% CI 1.024 to 4.860; p = 0.043). Further studies are needed to evaluate the reasons for the higher relapse rate causing higher mortality in obese patients.

Klíčová slova:

Body Mass Index – Cancer risk factors – Cancer treatment – Chemotherapy – Lymphomas – Obesity – Toxicity


Zdroje

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Článek vyšel v časopise

PLOS One


2019 Číslo 11