Background / Aims: The aim of this study is to compare the risk of treatment related toxicities (TRAEs) and long term survival between obese and non-obese patients with non-Hodgkin lymphoma when treated with full uncapped doses of R-CHOP (Rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) chemotherapy.
Methods: Patients with a BMI ? 30kg/m2 were classified as obese, and those with BMI less than 30kg/m2 non-obese. Overall survival (OS) was analysed for the entire cohort, and was the length of time between the commencement of treatment and death from any cause. Progression-free survival (PFS) was analysed amongst those who achieved at least a partial response on initial treatment, and was defined as the length of time (in months) between the commencement of treatment and either confirmed disease relapse or death by any cause. Demographic and clinical characteristics between the two BMI groups (obese and non-obese) were compared using independent T, Fisher’s exact, Pearson’s chi-square, and Mann-Whitney U tests. The primary outcomes were treatment related adverse events. Relationship between BMI and acute TRAEs were analysed using a scatter plot between TRAEs and BMI.
Results: A total of 133 patients and 733 cycles of chemotherapy were analysed. Obese patients did not experience an increased risk of acute treatment related toxicities (adjusted odds ratio 0.825, P = 0.197), or delayed toxicities (adjusted odds ratio 0.819, P = 0.779). In the subgroup of diffuse large B cell lymphoma patients (n = 109), treatment response rate was similar between the two BMI groups, and obese patients tended to have superior overall and progression free survivals, albeit not statistically significant.
Conclusions: Full uncapped doses of R-CHOP chemotherapy administered to obese patients with NHL are safe, well tolerated and do not lead to inferior treatment response or long term outcomes.
Counties Manukau Health