Gender and Body Mass Index May Effect Treatment Outcomes in Older DLBCL Patients

Though much of the lymphoma research presented at the Annual Meeting of the American Society of Hematology (ASH) in December 2014 focused on the growing number of novel therapies for this disease, a subset of presentations focused on the impact of non-pharmaceutical treatment issues such as patient quality of life, maintenance scans, and the presence or absence of various risk factors. These studies, a selection of which are summarized below, demonstrate that research beyond pharmaceutical trials is a crucial component of continuing to improve survival rates in lymphoma.

A study investigating the relationship between outcomes in DLBCL patients and their body mass index (BMI) and gender revealed that older men in particular have poorer outcomes at the current standard dose of rituximab (Rituxan). Researchers used the National Comprehensive Cancer Network (NCCN) non-Hodgkin lymphoma database to identify 1,386 DLBCL patients, 627 of whom were elderly (over 60), analyzing long-term outcomes such as progression free survival and overall survival at 3 years based on patient gender, age, and BMI. All patients received rituximab as part of their first-line treatment. The data revealed that, where patients had a BMI of less than 25 (not considered overweight), female patients had better outcomes than male patients, but that this advantage decreased in patients with BMI of more than 25. This discrepancy between genders was also found in the elderly patients, with elderly male patients with a BMI of less than 25 having the poorest outcomes, but not in patients younger than 60. Citing previous studies that suggested elderly men clear rituximab from their systems faster than other patient groups, the researchers noted that their reports support current ongoing trials to evaluate whether men older than 60 should receive enhanced rituximab dosing to improve their outcomes.

Researchers on this study included LRF Scientific Advisory Board members, Leo I. Gordon, MD of Northwestern University Medical Center, Ann S. LaCasce, MD of Dana-Farber Cancer Center, Myron S. Czuczman, MD of Rosewell Park Cancer Institute, Andrew D. Zelenetz, MD, PhD of Memorial Sloan Kettering Cancer Center, and Jonathan W. Friedberg, MD of the University of Rochester. The abstract of this study is available here.