Rituximab maintenance overcomes the negative prognostic factor of obesity in CLL: Subgroup analysis of the international randomized AGMT CLL-8a mabtenance trial.
Alexander EgleThomas MelchardtPetra ObrtlíkováLukáš SmolejTomáš KozákMichael SteurerJohannes AndelSonja BurgstallerEva MikuškováLiana GerchevaThomas NösslingerTomáš PapajíkMiriam LadickáMichael GirschikofskyMikuláš HrubiškoUlrich JägerDaniela VoskovaMartin PecherstorferEva KrálikováChristina BurcoveanuEmil SpasovAndreas PetzerGeorgi MihaylovJulian RaynovHorst OexleAugust ZaberniggEmília FlochováStanislav PalášthyOlga StehlíkováMichael DoubekPetra AltenhoferLukas WeissTeresa MagnesLisa PleyerAnton KlinglerJiří MayerRichard GreilPublished in: Cancer medicine (2019)
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.
Keyphrases
- chronic lymphocytic leukemia
- weight loss
- metabolic syndrome
- prognostic factors
- end stage renal disease
- obese patients
- type diabetes
- adipose tissue
- newly diagnosed
- ejection fraction
- insulin resistance
- chronic kidney disease
- phase iii
- diffuse large b cell lymphoma
- clinical trial
- study protocol
- high fat diet induced
- machine learning
- open label
- electronic health record
- patient reported
- placebo controlled