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

  • 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.
Metadaten
Author:Sebastian ScheichORCiD, Julius C. Enßle, Victoria Therese MückeORCiDGND, Fabian Acker, Lukas Aspacher, Sebastian Wolf, Anne Wilke, Sarah WeberORCiD, Uta BrunnbergGND, Hubert ServeORCiDGND, Björn SteffenGND
URN:urn:nbn:de:hebis:30:3-516211
DOI:https://doi.org/10.1371/journal.pone.0225035
ISSN:1932-6203
Pubmed Id:https://pubmed.ncbi.nlm.nih.gov/31703102
Parent Title (English):PLoS one
Publisher:PLoS
Place of publication:Lawrence, Kan.
Contributor(s):Senthilnathan Palaniyandi
Document Type:Article
Language:English
Year of Completion:2019
Date of first Publication:2019/11/08
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2019/11/11
Tag:Body mass index; Cancer risk factors; Cancer treatment; Chemotherapy; Lymphomas; Multivariate analysis; Obesity; Toxicity
Volume:14
Issue:(11): e0225035
Page Number:14
First Page:1
Last Page:14
Note:
Copyright: © 2019 Scheich et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
HeBIS-PPN:456404236
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 4.0