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Increased body mass index is associated with improved survival in United States veterans with diffuse large B-cell lymphoma.

Abstract

PURPOSE

Obesity increases the risk of death from many malignancies, including non-Hodgkin's lymphoma (NHL). In diffuse large B-cell lymphoma (DLBCL), the most common form of NHL, the association between body mass index (BMI) at diagnosis and survival is unclear.

PATIENTS AND METHODS

We evaluated the association between BMI at diagnosis and overall survival in a retrospective cohort of 2,534 United States veterans diagnosed with DLBCL between October 1, 1998 and December 31, 2008. Cox modeling was used to control for patient- and disease-related prognostic variables.

RESULTS

Mean age at diagnosis was 68 years (range, 20 to 100 years); 64% of patients were overweight (BMI, 25 to < 30) or obese (BMI, ≥ 30). Obese patients were significantly younger, had significantly fewer B symptoms, and trended toward lower-stage disease, compared with other BMI groups. Cox analysis showed reduced mortality in overweight and obese patients (overweight: hazard ratio [HR], 0.73; 95% CI, 0.65 to 0.83; obese: HR, 0.68; 95% CI, 0.58 to 0.80), compared with normal-weight patients (BMI, 18.5 to < 25). Treatment during the rituximab era reduced the risk of death without affecting the association between BMI and survival. Disease-related weight loss occurred in 29% of patients with weight data 1 year before diagnosis. Cox analysis based on BMI 1 year before diagnosis continued to demonstrate reduced risk of death in overweight and obese patients.

CONCLUSION

Being overweight or obese at the time of DLBCL diagnosis is associated with improved overall survival. Understanding the mechanisms responsible for this association will require further study.

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  • Authors+Show Affiliations

    ,

    St Louis Veterans Affairs Medical Center, Division of Oncology, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8056, St Louis, MO 63110, USA. kcarson@dom.wustl.edu

    , , , , , , ,

    Source

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Body Mass Index
    Female
    Humans
    Lymphoma, Large B-Cell, Diffuse
    Male
    Middle Aged
    Obesity
    Overweight
    Prognosis
    Retrospective Studies
    United States
    Veterans
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22649138

    Citation

    Carson, Kenneth R., et al. "Increased Body Mass Index Is Associated With Improved Survival in United States Veterans With Diffuse Large B-cell Lymphoma." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 30, no. 26, 2012, pp. 3217-22.
    Carson KR, Bartlett NL, McDonald JR, et al. Increased body mass index is associated with improved survival in United States veterans with diffuse large B-cell lymphoma. J Clin Oncol. 2012;30(26):3217-22.
    Carson, K. R., Bartlett, N. L., McDonald, J. R., Luo, S., Zeringue, A., Liu, J., ... Colditz, G. A. (2012). Increased body mass index is associated with improved survival in United States veterans with diffuse large B-cell lymphoma. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 30(26), pp. 3217-22. doi:10.1200/JCO.2011.39.2100.
    Carson KR, et al. Increased Body Mass Index Is Associated With Improved Survival in United States Veterans With Diffuse Large B-cell Lymphoma. J Clin Oncol. 2012 Sep 10;30(26):3217-22. PubMed PMID: 22649138.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Increased body mass index is associated with improved survival in United States veterans with diffuse large B-cell lymphoma. AU - Carson,Kenneth R, AU - Bartlett,Nancy L, AU - McDonald,Jay R, AU - Luo,Suhong, AU - Zeringue,Angelique, AU - Liu,Jingxia, AU - Fu,Qiang, AU - Chang,Su-Hsin, AU - Colditz,Graham A, Y1 - 2012/05/29/ PY - 2012/6/1/entrez PY - 2012/6/1/pubmed PY - 2012/12/10/medline SP - 3217 EP - 22 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J. Clin. Oncol. VL - 30 IS - 26 N2 - PURPOSE: Obesity increases the risk of death from many malignancies, including non-Hodgkin's lymphoma (NHL). In diffuse large B-cell lymphoma (DLBCL), the most common form of NHL, the association between body mass index (BMI) at diagnosis and survival is unclear. PATIENTS AND METHODS: We evaluated the association between BMI at diagnosis and overall survival in a retrospective cohort of 2,534 United States veterans diagnosed with DLBCL between October 1, 1998 and December 31, 2008. Cox modeling was used to control for patient- and disease-related prognostic variables. RESULTS: Mean age at diagnosis was 68 years (range, 20 to 100 years); 64% of patients were overweight (BMI, 25 to < 30) or obese (BMI, ≥ 30). Obese patients were significantly younger, had significantly fewer B symptoms, and trended toward lower-stage disease, compared with other BMI groups. Cox analysis showed reduced mortality in overweight and obese patients (overweight: hazard ratio [HR], 0.73; 95% CI, 0.65 to 0.83; obese: HR, 0.68; 95% CI, 0.58 to 0.80), compared with normal-weight patients (BMI, 18.5 to < 25). Treatment during the rituximab era reduced the risk of death without affecting the association between BMI and survival. Disease-related weight loss occurred in 29% of patients with weight data 1 year before diagnosis. Cox analysis based on BMI 1 year before diagnosis continued to demonstrate reduced risk of death in overweight and obese patients. CONCLUSION: Being overweight or obese at the time of DLBCL diagnosis is associated with improved overall survival. Understanding the mechanisms responsible for this association will require further study. SN - 1527-7755 UR - https://www.unboundmedicine.com/medline/citation/22649138/Increased_body_mass_index_is_associated_with_improved_survival_in_United_States_veterans_with_diffuse_large_B_cell_lymphoma_ L2 - http://ascopubs.org/doi/full/10.1200/JCO.2011.39.2100?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -