title: Anthropometrics and prognosis in diffuse large B-cell lymphoma: a multicentre study of 653 patients.
abstract: OBJECTIVE
  The impact of body mass index (BMI) and body surface area (BSA) on survival in diffuse large B-cell lymphoma (DLBCL) is controversial. Recent studies show superior outcomes for overweight and obese patients.
  
  
  METHODS
  A total of 653 R-CHOP(-like)-treated DLBCL patients were included in this retrospective cohort study. Patients, baseline clinicopathologic characteristics and treatment information were retrieved from the Danish Lymphoma Registry. Anthropometric measures were obtained from chemotherapy prescription charts.
  
  
  RESULTS
  Underweight (BMI <18.5 kg/m2) was associated with significantly worse progression-free survival (PFS) for male patients only in sex-stratified analyses (HR 3.92, 95% CI: 1.57-9.75, P = 0.003, for males; HR 1.65, 95% CI: 0.90-3.02, P = 0.107, for females). In multivariate analyses, underweight was associated with worse PFS for both sexes (HR 5.34, 95% CI: 2.07-13.79, P = 0.001, for males; HR 2.14, 95% CI: 1.12-4.08, P = 0.021, for females). Similar results were obtained in analyses of overall survival. In crude analyses, BSA <1.8 m2was associated with worse PFS for men and women (HR 1.65, 95% CI: 1.03-2.65, P = 0.039, for men; HR 1.62, 95% CI: 1.03-2.56, P = 0.037, for women). In multivariate analyses, however, these associations diminished.
  
  
  CONCLUSIONS
  Our study demonstrates that underweight DLBCL patients have worse outcomes following R-CHOP as compared to normal as well as overweight patients.
authors.affiliation: Department of Haematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark.|Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Mette Dahl
authors.identifier: http://orcid.org/0000-0003-2403-3520
authors.initials: MD
authors.lastname: Bendtsen
authors.affiliation: Department of Haematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Peter Svenssen
authors.initials: PS
authors.lastname: Munksgaard
authors.affiliation: Department of Haematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark.|Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: Marianne Tang
authors.initials: MT
authors.lastname: Severinsen
authors.affiliation: Department of Haematology, Odense University Hospital, Odense, Denmark.
authors.forename: Eric
authors.initials: E
authors.lastname: Bekric
authors.affiliation: Department of Haematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Brieghel
authors.affiliation: Department of Haematology, Holstebro Hospital, Holstebro, Denmark.
authors.forename: Kristina Buchardi
authors.initials: KB
authors.lastname: Nielsen
authors.affiliation: Department of Haematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Peter de Nully
authors.initials: PN
authors.lastname: Brown
authors.affiliation: Department of Haematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark.|Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: Karen
authors.initials: K
authors.lastname: Dybkaer
authors.affiliation: Department of Haematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark.|Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: Hans Erik
authors.initials: HE
authors.lastname: Johnsen
authors.affiliation: Department of Haematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark.|Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: Martin
authors.initials: M
authors.lastname: Bøgsted
authors.affiliation: Department of Haematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark.|Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: Tarec Christoffer
authors.initials: TC
authors.lastname: El-Galaly
mesh_terms: D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D015992:Body Mass Index; D001830:Body Surface Area; D003520:Cyclophosphamide / Q000008:administration & dosage; D003718:Denmark; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D050177:Overweight; D011241:Prednisone / Q000008:administration & dosage; D012042:Registries; D012189:Retrospective Studies; D000069283:Rituximab; D015996:Survival Rate; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: body mass index; body surface area; diffuse large B-cell lymphoma; prognosis; survival