Body Mass Index, Weight Change, and Survival in Non-Hodgkin Lymphoma Patients in Connecticut Women

Abstract

Background Evidence is emerging that obesity and weight gain may affect the prognosis of several types of cancer. We investigated the impact of body mass index (BMI) as well as pre- and post-diagnosis weight changes on non-Hodgkin lymphoma (NHL) prognosis. Methods A cohort of 573 female incident NHL cases diagnosed during 1996–2000 in Connecticut was followed for a median of 7.8 years. Self-reported height and weight at three time points before and after diagnosis were collected. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using proportional hazard models adjusting for factors believed to be associated with overall survival of NHL. Results Underweight (BMI < 18.5; HR = 2.84; 95% CI = 1.12–7.15) before diagnosis was associated with poorer survival compared to being normal weight (18.5 <= BMI < 25). Pre-diagnosis weight loss (HR = 1.42; 95% CI = 1.02–1.97) and post-treatment weight loss (HR = 1.98; 95% CI = 1.14–3.45) and weight gain (HR = 1.85; 95% CI = 1.04–3.32) were associated with poorer survival. Conclusion NHL patients who were underweight, lost weight pre-diagnosis, or change weight after treatment were found to have a poorer survival.

Obesity and non-Hodgkin lymphoma survival in an ethnically diverse population: the Multiethnic Cohort study

“…Our results are consistent with the lower survival of obese patients in two previous reports (10, 29), which assessed self-reported height and weight at least 1 year before diagnosis. A study that had information on weight near the time of diagnosis found no association between obesity and survival or even improved survival (13).…”

“…Previous studies mostly showed non-significant associations between obesity and poorer overall survival for DLBCL, CLL/SLL, and FL (10, 29). A retrospective study on United States Veterans with DLBCL (14) indicated a protective effect of overweight and obesity, but only 70% of all cases were included in the analysis and the inability to obtain information for all cases may have biased the results.…”

“…Most studies in NHL patients to date reported on overall mortality only (11, 13, 14, 29) although one report detected similar patterns of association for the 273 deaths due to lymphoma (10). Previous cohort studies detected higher NHL-related mortality in their participants with excess body weight but did not examine survival specifically in cases (15–17).…”

“…The 5-year relative survival rate of 67% in the MEC cases was very similar to rates reported by SEER, which ranged from 59–71% between 1996 and 2010 (3). Most of the previous reports were based on case-control studies (10, 11, 29), which may not have enrolled a sufficient numbers of patients with advanced stage disease and more aggressive NHL types. Further, previous clinical studies may not be representative of all NHL cases due to strict inclusion criteria (13, 14, 44, 45).…”

Systemic Immune-inflammation Index, Based on Platelet Counts and Neutrophil-Lymphocyte Ratio, Is Useful for Predicting Prognosis in Small Cell Lung Cancer

“…Therefore, the consistency of roles of patients and therapy characteristics for prognosis with previous studies illustrated the reliability of case data in this study. The impact of BMI on prognosis in SCLC, considering its effects on the prognosis of several cancers (Pai et al 2012;Han et al 2013) was evaluated. The results showed a lack of any association between BMI and clinical outcomes in patients with SCLC.…”