Rituximab maintenance overcomes the negative prognostic factor of obesity in CLL: Subgroup analysis of the international randomized AGMT CLL-8a mabtenance trial
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články, randomizované kontrolované studie
PubMed
30888118
PubMed Central
PMC6488104
DOI
10.1002/cam4.1980
Knihovny.cz E-zdroje
- Klíčová slova
- BMI, CLL, maintenance, obesity, rituximab,
- MeSH
- analýza přežití MeSH
- chronická lymfatická leukemie farmakoterapie mortalita MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- obezita komplikace mortalita MeSH
- prognóza MeSH
- rituximab aplikace a dávkování terapeutické užití MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- udržovací chemoterapie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
- Názvy látek
- rituximab MeSH
No data are available regarding obesity and outcome in Chronic Lymphocytic Leukemia (CLL). We analyzed 263 patients from the AGMT CLL-8a Mabtenance trial for the impact of obesity. The trial included patients after rituximab-containing induction treatment in first or second line that had achieved at least a PR. A randomization to rituximab maintenance treatment (375 mg/m2 q3 months for 2 years) vs observation was performed. In this cohort 22% of the patients (58/263) were classified as obese. The baseline response to induction treatment was inferior in obese patients with a lower CR rate (43.1% vs 60.5% in obese vs non-obese, P = 0.018) and with a lower rate of patients achieving MRD negativity after chemoimmunotherapy induction treatment (19.6% vs 35.8%, P = 0.02). The PFS outcome of obese patients was significantly worse in the observation group of the trial (24 vs 39 months median PFS, P = 0.03). However, in the rituximab maintenance group the outcome for obese vs non-obese was not different (P = 0.4). In summary, obesity was overall associated with a worse outcome of chemoimmunotherapy induction. However, rituximab maintenance treatment seems to be able to overcome this negative effect.
3rd Medical Department Paracelsus Medical University Salzburg Salzburg Austria
Assign Data Management and Biostatistics GmbH Innsbruck Austria
Cancer Cluster Salzburg Salzburg Austria
Clinic of Haematology Regional Institute of Oncology Iasi Iasi Romania
Clinic of Hematology UMHAT St George and Medical University Plovdiv Plovdiv Bulgaria
Clinic of Hematology University Hospital St Marina Varna Varna Bulgaria
Clinic of Medical Hematology Military Medical Academy Sofia Sofia Bulgaria
Department of Clinical Hematology FNsP J A Reimana Prešov Prešov Slovakia
Department of Clinical Oncology 1 National Cancer Institute Bratislava Bratislava Slovakia
Department of Hemato oncology 2 National Cancer Institute Bratislava Bratislava Slovakia
Department of Hemato oncology University Hospital Olomouc Olomouc Czech Republic
Department of Hematology and Transfusion University Hospital Martin Martin Slovakia
Department of Hematology FNsP F D Roosevelta Banská Bystrica Banska Bystrica Slovakia
Department of Internal Medicine 3 Kepler Universitätsklinikum GmbH Med Campus 3 Linz Austria
Department of Internal Medicine 4 Klinikum Wels Grieskirchen GmbH Wels Austria
Department of Internal Medicine 5 Medical University Innsbruck Innsbruck Austria
Faculty of Medicine and CEITEC University Hospital Brno Brno Czech Republic
Hematological Clinic NSHATHD Sofia Queen Joanna University Hospital Sofia Bulgaria
Innere Medizin 1 Ordensklinikum Linz GmbH Linz Austria
Innere Medizin 2 Bezirkskrankenhaus Kufstein Kufstein Austria
Innere Medizin Landeskrankenhaus Hall Hall in Tirol Austria
Internal Medicine 2 Hospital of Steyr Steyr Austria
Interne Abteilung Ordensklinikum Linz GmbH Elisabethinen Linz Austria
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Wolin KY, Carson K, Colditz GA. Obesity and cancer. Oncologist. 2010;15(6):556‐565. PubMed PMC
Jager U, Fridrik M, Zeitlinger M, et al. Rituximab serum concentrations during immuno‐chemotherapy of follicular lymphoma correlate with patient gender, bone marrow infiltration and clinical response. Haematologica. 2012;97(9):1431‐1438. PubMed PMC
Muller C, Murawski N, Wiesen M, et al. The role of sex and weight on rituximab clearance and serum elimination half‐life in elderly patients with DLBCL. Blood. 2012;119(14):3276‐3284. PubMed
Greil R, Obrtlíková P, Smolej L, et al. Rituximab maintenance versus observation alone in patients with chronic lymphocytic leukaemia who respond to first‐line or second‐line rituximab‐containing chemoimmunotherapy: final results of the AGMT CLL‐8a Mabtenance randomised trial. Lancet Haematol. 2016;3(7):e317‐e329. PubMed
Pfreundschuh M, Muller C, Zeynalova S, et al. Suboptimal dosing of rituximab in male and female patients with DLBCL. Blood. 2014;123(5):640‐646. PubMed
Jaeger U, Trneny M, Melzer H, et al. Rituximab maintenance for patients with aggressive B‐cell lymphoma in first remission: results of the randomized NHL13 trial. Haematologica. 2015;100(7):955‐963. PubMed PMC
Bottcher S, Ritgen M, Fischer K, et al. Minimal residual disease quantification is an independent predictor of progression‐free and overall survival in chronic lymphocytic leukemia: a multivariate analysis from the randomized GCLLSG CLL8 trial. J Clin Oncol. 2012;30(9):980‐988. PubMed
Vimaleswaran KS, Berry DJ, Lu C, et al. Causal relationship between obesity and vitamin D status: bi‐directional Mendelian randomization analysis of multiple cohorts. PLoS Med.. 2013;10(2):e1001383. PubMed PMC