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Body mass index as a prognostic factor in Asian patients treated with chemoimmunotherapy for diffuse large B cell lymphoma, not otherwise specified.
Ann Hematol 2015; 94(10):1655-65AH

Abstract

Obesity was recently reported to confer a survival advantage in diffuse large B cell lymphoma (DLBCL) among Western populations. Given ethnic differences, previous studies recommended a revision of the WHO classification of obesity for Asians. We investigated the prognostic impact of body mass index (BMI) using modified WHO criteria in a retrospective cohort of 562 Korean patients with DLBCL. Patients were categorized into five groups according to BMI: 26 (4.6 %) as underweight (<18.5 kg/m(2)), 230 (40.9 %) as normal weight (18.5-22.9 kg/m(2)), 129 (23.0 %) as overweight (23.0-24.9 kg/m(2)), 160 (28.5 %) as obese (25.0-29.9 kg/m(2)), and 17 (3.0 %) as severely obese (≥30 kg/m(2)). As BMI increased, the relative hazard ratio (HR) decreased sharply, reaching the lowest value in the overweight group, and then rose again in the obese and severely obese. On univariate analysis, both overall survival (OS) and progression-free survival (PFS) were best in the overweight group, followed by normal > obese > severely obese > underweight groups. Multivariate analysis showed a significantly shorter survival in the underweight (OS: HR 2.90, 95 % confidence interval (CI) 1.35-6.19, P = 0.006; PFS: HR 3.08, 95 % CI 1.55-6.09, P = 0.001) and severely obese groups (OS: HR 2.93, 95 % CI 1.08-7.95, P = 0.035; PFS: HR 2.59, 95 % CI 1.06-6.36, P = 0.038). We show that being underweight or, contrary to findings in Western patients, being severely obese has a deleterious prognostic impact in DLBCL in Koreans. Revising the BMI criterion that defines obesity according to the patient's ethnic differences could therefore better delineate DLBCL risk groups in Asian patients.

Authors+Show Affiliations

Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Seoul, 138-736, Korea.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26174908

Citation

Hwang, Hee Sang, et al. "Body Mass Index as a Prognostic Factor in Asian Patients Treated With Chemoimmunotherapy for Diffuse Large B Cell Lymphoma, Not Otherwise Specified." Annals of Hematology, vol. 94, no. 10, 2015, pp. 1655-65.
Hwang HS, Yoon DH, Suh C, et al. Body mass index as a prognostic factor in Asian patients treated with chemoimmunotherapy for diffuse large B cell lymphoma, not otherwise specified. Ann Hematol. 2015;94(10):1655-65.
Hwang, H. S., Yoon, D. H., Suh, C., & Huh, J. (2015). Body mass index as a prognostic factor in Asian patients treated with chemoimmunotherapy for diffuse large B cell lymphoma, not otherwise specified. Annals of Hematology, 94(10), pp. 1655-65. doi:10.1007/s00277-015-2438-4.
Hwang HS, et al. Body Mass Index as a Prognostic Factor in Asian Patients Treated With Chemoimmunotherapy for Diffuse Large B Cell Lymphoma, Not Otherwise Specified. Ann Hematol. 2015;94(10):1655-65. PubMed PMID: 26174908.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Body mass index as a prognostic factor in Asian patients treated with chemoimmunotherapy for diffuse large B cell lymphoma, not otherwise specified. AU - Hwang,Hee Sang, AU - Yoon,Dok Hyun, AU - Suh,Cheolwon, AU - Huh,Jooryung, Y1 - 2015/07/15/ PY - 2015/02/10/received PY - 2015/06/22/accepted PY - 2015/7/16/entrez PY - 2015/7/16/pubmed PY - 2015/12/15/medline SP - 1655 EP - 65 JF - Annals of hematology JO - Ann. Hematol. VL - 94 IS - 10 N2 - Obesity was recently reported to confer a survival advantage in diffuse large B cell lymphoma (DLBCL) among Western populations. Given ethnic differences, previous studies recommended a revision of the WHO classification of obesity for Asians. We investigated the prognostic impact of body mass index (BMI) using modified WHO criteria in a retrospective cohort of 562 Korean patients with DLBCL. Patients were categorized into five groups according to BMI: 26 (4.6 %) as underweight (<18.5 kg/m(2)), 230 (40.9 %) as normal weight (18.5-22.9 kg/m(2)), 129 (23.0 %) as overweight (23.0-24.9 kg/m(2)), 160 (28.5 %) as obese (25.0-29.9 kg/m(2)), and 17 (3.0 %) as severely obese (≥30 kg/m(2)). As BMI increased, the relative hazard ratio (HR) decreased sharply, reaching the lowest value in the overweight group, and then rose again in the obese and severely obese. On univariate analysis, both overall survival (OS) and progression-free survival (PFS) were best in the overweight group, followed by normal > obese > severely obese > underweight groups. Multivariate analysis showed a significantly shorter survival in the underweight (OS: HR 2.90, 95 % confidence interval (CI) 1.35-6.19, P = 0.006; PFS: HR 3.08, 95 % CI 1.55-6.09, P = 0.001) and severely obese groups (OS: HR 2.93, 95 % CI 1.08-7.95, P = 0.035; PFS: HR 2.59, 95 % CI 1.06-6.36, P = 0.038). We show that being underweight or, contrary to findings in Western patients, being severely obese has a deleterious prognostic impact in DLBCL in Koreans. Revising the BMI criterion that defines obesity according to the patient's ethnic differences could therefore better delineate DLBCL risk groups in Asian patients. SN - 1432-0584 UR - https://www.unboundmedicine.com/medline/citation/26174908/Body_mass_index_as_a_prognostic_factor_in_Asian_patients_treated_with_chemoimmunotherapy_for_diffuse_large_B_cell_lymphoma_not_otherwise_specified_ L2 - https://dx.doi.org/10.1007/s00277-015-2438-4 DB - PRIME DP - Unbound Medicine ER -