title: The role of body mass index in survival outcome for lymphoma patients: US intergroup experience.
abstract: BACKGROUND
  The role of body mass index (BMI) in survival outcomes is controversial among lymphoma patients. We evaluated the association between BMI at study entry and failure-free survival (FFS) and overall survival (OS) in three phase III clinical trials, among patients with diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL) and Hodgkin's lymphoma (HL).
  
  
  METHODS
  A total of 537, 730 and 282 patients with DLBCL, HL and FL were included in the analysis. Baseline patient and clinical characteristics, treatment received and clinical outcomes were compared across BMI categories.
  
  
  RESULTS
  Among patients with DLBCL, HL and FL, the median age was 70, 33 and 56; 29%, 29% and 37% were obese and 38%, 27% and 37% were overweight, respectively. Age was significantly different among BMI groups in all three studies. Higher BMI groups tended to have more favorable prognosis factors at study entry among DLBCL and HL patients. BMI was not associated with clinical outcome with P-values of 0.89, 0.30 and 0.40 for FFS, and 0.64, 0.67 and 0.09 for OS, for patients with DLBCL, HL and FL, respectively. The association remains non-significant after adjusting for other clinical factors in the Cox model. A subset analysis of males with DLBCL treated on R-CHOP revealed no differences in FFS (P = 0.48) or OS (P = 0.58).
  
  
  CONCLUSIONS
  BMI was not significantly associated with clinical outcomes among patients with DLBCL, HD or FL, in three prospective phase III clinical trials. The findings contradict some previous reports of similar investigations. Further work is required to understand the observed discrepancies.
authors.affiliation: Dana Farber Cancer Institute, Boston, MA. Electronic address: fxhong@jimmy.harvard.edu.
authors.forename: F
authors.initials: F
authors.lastname: Hong
authors.affiliation: Mayo Clinic, Rochester, MN.
authors.forename: T M
authors.initials: TM
authors.lastname: Habermann
authors.affiliation: Northwestern University, Chicago, IL.
authors.forename: L I
authors.initials: LI
authors.lastname: Gordon
authors.affiliation: Yale University, New Haven, CT, USA.
authors.forename: H
authors.initials: H
authors.lastname: Hochster
authors.affiliation: British Columbia Cancer Agency, Vancouver, Canada.
authors.forename: R D
authors.initials: RD
authors.lastname: Gascoyne
authors.affiliation: University of Minnesota, VA Medical Center, Minneapolis, MN.
authors.forename: V A
authors.initials: VA
authors.lastname: Morrison
authors.affiliation: Fox Chase Cancer Center, Philadelphia, PA.
authors.forename: R I
authors.initials: RI
authors.lastname: Fisher
authors.affiliation: Washington University, St Louis, MO.
authors.forename: N L
authors.initials: NL
authors.lastname: Bartlett
authors.affiliation: Loyola University, Maywood, IL.
authors.forename: P J
authors.initials: PJ
authors.lastname: Stiff
authors.affiliation: Georgetown University Hospital, Washington, DC, USA.
authors.forename: B D
authors.initials: BD
authors.lastname: Cheson
authors.affiliation: Princess Margaret Hospital, Toronto, Ontario, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Crump
authors.affiliation: Genentech, Inc., South San Francisco, CA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Horning
authors.affiliation: University of Wisconsin, Madison, WI, USA.
authors.forename: B S
authors.initials: BS
authors.lastname: Kahl
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015992:Body Mass Index; D003520:Cyclophosphamide / Q000627:therapeutic use; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D008224:Lymphoma, Follicular / Q000188:drug therapy / Q000401:mortality*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000401:mortality*; D011241:Prednisone / Q000627:therapeutic use; D011446:Prospective Studies; D000069283:Rituximab; D016896:Treatment Outcome; D014481:United States; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: Hodgkin's lymphoma; body mass index; diffuse large B-cell lymphoma; follicular lymphoma; survival outcomes