Tarella C, Caracciolo D, Gavarotti P, Argentino C, Zallio F, Corradini P, Novero D, Magnani C, Pileri A
Dipartimento di Medicina e Oncologia Sperimentale, Divisione Universitaria di Ematologia, Azienda Ospedaliera S Giovanni Battista, Torino, Italy.
Bone Marrow Transplant. 2000 Dec;26(11):1185-91. doi: 10.1038/sj.bmt.1702692.
Despite detailed evaluation of disease-associated prognostic factors, little is known about the impact of overweight in autograft programs for non-Hodgkin's lymphoma (NHL) patients. In order to address this issue, 121 NHL patients were retrospectively evaluated. They had been upfront (92 patients) or in relapse (29 patients) and received high-dose sequential (HDS) chemotherapy including peripheral blood progenitor cell (PBPC) autograft. Body mass index (BMI) was calculated as weight in kilograms divided by the square of the height in meters; overweight was defined as BMI > or = 28. Univariate and multivariate analyses were used to determine the prognostic implication of overweight and other known prognostic indicators on overall (OS) and event-free (EFS) survival for the entire group and overweight and non-overweight (reference) subgroups. With a median follow-up of 3 years, the estimated 5-year OS and EFS for the entire group were 58% and 49%, respectively. Twenty-eight patients (23%) had BMI > or = 28. Their median OS and EFS were 2.2 and 1.4 years, respectively, whereas median OS and EFS for the reference group have not been reached, with a 5-year projection of 65 and 55%, respectively (P < 0.002). On multivariate analysis, the risk of death among overweight patients was 2.9 (CI, 1.3-6.2) times that of the reference group; using EFS as the end point, a similar association between overweight and survival was observed. In conclusion, in high-risk NHL patients undergoing intensive chemotherapy and PBPC autografting overweight is associated with a poorer outcome.
尽管对疾病相关的预后因素进行了详细评估，但对于超重对非霍奇金淋巴瘤（NHL）患者自体移植方案的影响知之甚少。为了解决这个问题，对121例NHL患者进行了回顾性评估。他们处于初治阶段（92例患者）或复发阶段（29例患者），并接受了包括外周血祖细胞（PBPC）自体移植的大剂量序贯（HDS）化疗。体重指数（BMI）计算为体重（千克）除以身高（米）的平方；超重定义为BMI≥28。采用单因素和多因素分析来确定超重及其他已知预后指标对整个组以及超重和非超重（参照）亚组的总生存期（OS）和无事件生存期（EFS）的预后意义。中位随访3年，整个组的估计5年OS和EFS分别为58%和49%。28例患者（23%）BMI≥28。他们的中位OS和EFS分别为2.2年和1.4年，而参照组的中位OS和EFS尚未达到，5年预测值分别为65%和55%（P<0.002）。多因素分析显示，超重患者的死亡风险是参照组的2.9倍（CI，1.3 - 6.2）；以EFS作为终点，超重与生存之间也观察到类似关联。总之，在接受强化化疗和PBPC自体移植的高危NHL患者中，超重与较差的预后相关。
