Publication details

Rituximab maintenance overcomes the negative prognostic factor of obesity in CLL: Subgroup analysis of the international randomized AGMT CLL-8a mabtenance trial

Authors	EGLE Alexander MELCHARDT Thomas OBRTLIKOVA Petra SMOLEJ Lukas KOZAK Tomas STEURER Michael ANDEL Johannes BURGSTALLER Sonja MIKUSKOVA Eva GERCHEVA Liana NOSSLINGER Thomas PAPAPJIK Tomas LADICKA Miriam GIRSCHIKOFSKY Michael HRUBISKO Mikulas JAGER Ulrich VOSKOVA Daniela PECHERSTORFER Martin KRALIKOVA Eva BURCOVEANU Christina SPASOV Emil PETZER Andreas MIHAYLOV Georgi RAYNOV Julian OEXLE Horst ZABERNIGG August FLOCHOVA Emilia PALASTHY Stanislav STEHLÍKOVÁ Olga DOUBEK Michael ALTENHOFER Petra WEISS Lukas MAGNES Teresa PLEYER Lisa KLINGLER Anton MAYER Jiří GREIL Richard
Year of publication	2019
Type	Article in Periodical
Magazine / Source	Cancer Medicine
MU Faculty or unit	Faculty of Medicine
Citation
Web	http://dx.doi.org/10.1002/cam4.1980
Doi	http://dx.doi.org/10.1002/cam4.1980
Keywords	BMI; CLL; maintenance; obesity; rituximab
Description	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 (375mg/m(2) q3 months for 2years) 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 39months 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.