Body mass index and other anthropometric parameters in patients with diffuse large B-cell lymphoma: physiopathological significance and predictive value in the immunochemotherapy era

Leuk Lymphoma. 2015 Jul;56(7):1959-68. doi: 10.3109/10428194.2014.979412. Epub 2015 Jan 21.

Abstract

Diffuse large B-cell lymphoma (DLBCL) is the most common form of aggressive non-Hodgkin lymphoma, accounting for 30-40% of newly diagnosed cases. Obesity is a well-defined risk factor for DLBCL. However, the impact of body mass index (BMI) on DLBCL prognosis is controversial. Recent studies suggest that skeletal muscle wasting (sarcopenia) or loss of fat mass can be detected by computed tomography (CT) images and is useful for predicting the clinical outcome in several types of cancer including DLBCL. Several hypotheses have been proposed to explain the differences in DLBCL outcome according to BMI or weight that include tolerance to treatment, inflammatory background and chemotherapy or rituximab metabolism. In this review, we summarize the available literature, addressing the impact and physiopathological relevance of simple anthropometric tools including BMI and tissue distribution measurements. We also discuss their relationship with other nutritional parameters and their potential role in the management of patients with DLBCL.

Keywords: Diffuse large B-cell lymphoma; body mass index; cachexia; obesity; prognosis; rituximab; sarcopenia.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / adverse effects*
  • Body Mass Index*
  • Humans
  • Immunotherapy*
  • Lymphoma, Large B-Cell, Diffuse / complications
  • Lymphoma, Large B-Cell, Diffuse / drug therapy
  • Lymphoma, Large B-Cell, Diffuse / pathology*
  • Obesity / complications
  • Prognosis
  • Sarcopenia / chemically induced
  • Sarcopenia / diagnosis*

Substances

  • Antibodies, Monoclonal