Can Body Mass Index Predict the Outcome of Diffuse Large B-Cell Lymphoma? - a Single-Center Retrospective Study in China

Body mass index (BMI), as a rough indicator of obesity, has been increasing over the years, along with a high incidence of cardiovascular disease and many malignancies, including diffuse large B-cell lymphoma (DLBCL). However, the predictive prognostic value of BMI at diagnosis for the outcome of DLBCL is controversial. So far, the reported study population has rarely been Chinese. We aimed to assess whether BMI can predict the outcome of Chinese DLBCL patients.

We carried out a single-center retrospective study to assess the predictive value of BMI in the outcome of Chinese patients with DLBCL. Among a total of 207 patients who were newly diagnosed with DLBCL in our center between January 2008 and May 2015, 143 eligible patients were enrolled. These patients were stratified into two groups, 74 patients in the low BMI group (BMI<23.0kg/m²)and 69 patients in the high BMI group (BMI≥23.0kg/m²). We compared the baseline characteristics in the low and high BMI groups, and complete remission (CR), partial remission (PR) and progressive disease (PD) as primary response criteria in the two groups. Univariate and multivariate analyses were used to evaluate whether low or high BMI had an impact on progression-free survival (PFS) and overall survival (OS).

Well-known influence factors including age, Ca125, B2-microglobulin, international prognostic index, B symptoms, Ann Arbor stage and the use of rituximab were similar between the two groups, while gender was not (P<0.023) but did not act as a risk factor. Besides, drug dose did not vary by BMI. No association between BMI and primary response was observed. Patients in the higher BMI group were inclined to have better OS (p=0.008), but we did not find an association between BMI and PFS (p=0.069).

Higher BMI at diagnosis may predict a longer OS, especially for female patients but may not affect the outcome of primary response and PFS. Multi-center and prospective studies are warranted to see if this holds true for the general Chinese DLBCL population, and mechanistic investigations may lead to new treatment options.