Obesity as a Poor Prognostic Factor in Multiple Myeloma

AUTOIMMUNE THROMBOCYTOPENIA ,

ES Mikhailov1, GN Salogub1, SS Bessmeltsev2

1 VA Almazov National Medical Research Center, 2 Akkuratova str., Saint Petersburg, Russian Federation, 197341

2 Russian Research Institute of Hematology and Transfusiology, 16 2-ya Sovetskaya str., Saint Petersburg, Russian Federation, 191024

For correspondence: Evgenii Sergeevich Mikhailov, 2 Akkuratova str., Saint Petersburg, Russian Federation, 197341; Tel.: +7(812)702-37-49; e-mail: mikhailov_md@bk.ru

For citation: Mikhailov ES, Salogub GN, Bessmeltsev SS. Obesity as a Poor Prognostic Factor in Multiple Myeloma. Clinical oncohematology. 2021;14(3):315–20. (In Russ).

DOI: 10.21320/2500-2139-2021-14-3-315-320

ABSTRACT

Aim. To assess the impact of obesity and overweight on the outcomes of multiple myeloma (MM) treatment.

Materials & Methods. The present retrospective study enrolled 214 patients with newly diagnosed MM. The median age was 59 years (range 29–89 years), male patients accounted for 40.2 %. The analysis focused on complication incidence, overall survival, and time to the second-line therapy depending on body mass index (BMI) at disease onset.

Results. In the groups of patients with BMI > 35 kg/m2 and BMI ≤ 35 kg/m2 the median overall survival was 42 and 95 months, respectively (hazard ratio [HR] 0.17; 95% confidence interval [95% CI] 0.08–0.37; p < 0.05). In the group of patients with obesity ≥ grade 2 the median time to the second-line therapy was 25 months, being less than in the group of patients with BMI ≤ 35 kg/m2 (43 months; HR 0.58; 95% CI 0.31–0.99; p < 0.05). As a result of therapy, the incidence of corticosteroid-associated hyperglycemia and infectious complications as well as the rate of delayed initiation of the next cycle and dose reduction of anticancer drugs were significantly higher in patients with BMI > 35 kg/m2 (p < 0.05).

Conclusion. Obesity ≥ grade 2 is a poor prognostic factor for complications and is associated with diminishing outcomes of ММ treatment. Accompanying morbid obesity leads to a higher incidence of therapy complications longer intervals between chemotherapy courses and drug dose reduction.

Keywords: multiple myeloma, obesity, prognosis, survival.

Received: March 9, 2021

Accepted: June 15, 2021

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Статистика Plumx английский

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