Obesity as a Poor Prognostic Factor in Multiple Myeloma

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.

• Evgenii Sergeevich Mikhailov VA Almazov National Medical Research Center, 2 Akkuratova str., Saint Petersburg, Russian Federation, 197341 ; ФГБУ «НМИЦ им. В.А. Алмазова» Минздрава России, ул. Аккуратова, д. 2, Санкт-Петербург, Российская Федерация, 197341
• G.N. Salogub VA Almazov National Medical Research Center, 2 Akkuratova str., Saint Petersburg, Russian Federation, 197341 ; ФГБУ «НМИЦ им. В.А. Алмазова» Минздрава России, ул. Аккуратова, д. 2, Санкт-Петербург, Российская Федерация, 197341
• S.S. Bessmeltsev Russian Research Institute of Hematology and Transfusiology, 16 2-ya Sovetskaya str., Saint Petersburg, Russian Federation, 191024 ; ФГБУ «Российский НИИ гематологии и трансфузиологии ФМБА России», ул. 2-я Советская, д. 16, Санкт-Петербург, Российская Федерация, 191024

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