Increased Body Mass Index Is Associated With Improved Survival in United States Veterans With Diffuse Large B-Cell Lymphoma
Increased Body Mass Index Is Associated With Improved Survival in United States Veterans With Diffuse Large B-Cell Lymphoma
复制标题
DOI：
10.1200/jco.2011.39.2100
复制
发表时间：
2012-09-10
影响因子：
45.3
通讯作者：
Colditz, Graham A.
中科院分区：
文献类型：
--
作者：
Carson, Kenneth R.;Bartlett, Nancy L.;Colditz, Graham A.
肥胖增加了许多恶性肿瘤的死亡风险，包括非霍奇金淋巴瘤（NHL）。在弥漫性大B细胞淋巴瘤（DLBCL），最常见的形式NHL，诊断和生存的体重指数（BMI）之间的关联是unclear.Patients和MethodsWe评估的BMI之间的关联在诊断和总生存在一个回顾性队列的2,534美国退伍军人诊断DLBCL 1998年10月1日至2008年12月31日。考克斯模型用于控制患者和疾病相关的预后variable.ResultsMean年龄诊断为68岁（范围，20至100岁），64%的患者超重（BMI，25至<30）或肥胖（BMI，>= 30）。与其他BMI组相比，肥胖患者显着年轻，B症状显着较少，并且倾向于较低阶段的疾病。考克斯分析显示，与正常体重患者（BMI，18.5至<25）相比，超重和肥胖患者的死亡率降低（超重：风险比[HR]，0.73; 95%CI，0.65至0.83;肥胖：HR，0.68; 95%CI，0.58至0.80）。利妥昔单抗时代的治疗降低了死亡风险，而不影响BMI和生存率之间的关联。在诊断前1年有体重数据的患者中，29%发生了疾病相关的体重减轻。考克斯分析的基础上BMI诊断前1年继续证明超重和肥胖patients.ConclusionBeing超重或肥胖的DLBCL诊断时的死亡风险降低与改善总生存率。了解这种联系的机制需要进一步研究。J Clin Oncol 30：3217 - 3222. (C)2012年美国临床肿瘤学会
PurposeObesity 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 MethodsWe 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.ResultsMean 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.ConclusionBeing 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. J Clin Oncol 30:3217-3222. (C) 2012 by American Society of Clinical Oncology