Cancer Medicine (Apr 2019)
Rituximab maintenance overcomes the negative prognostic factor of obesity in CLL: Subgroup analysis of the international randomized AGMT CLL‐8a mabtenance trial
- Alexander Egle,
- Thomas Melchardt,
- Petra Obrtlíková,
- Lukáš Smolej,
- Tomáš Kozák,
- Michael Steurer,
- Johannes Andel,
- Sonja Burgstaller,
- Eva Mikušková,
- Liana Gercheva,
- Thomas Nösslinger,
- Tomáš Papajík,
- Miriam Ladická,
- Michael Girschikofsky,
- Mikuláš Hrubiško,
- Ulrich Jäger,
- Daniela Voskova,
- Martin Pecherstorfer,
- Eva Králiková,
- Christina Burcoveanu,
- Emil Spasov,
- Andreas Petzer,
- Georgi Mihaylov,
- Julian Raynov,
- Horst Oexle,
- August Zabernigg,
- Emília Flochová,
- Stanislav Palášthy,
- Olga Stehlíková,
- Michael Doubek,
- Petra Altenhofer,
- Lukas Weiss,
- Teresa Magnes,
- Lisa Pleyer,
- Anton Klingler,
- Jiří Mayer,
- Richard Greil
Affiliations
- Alexander Egle
- Third Medical Department Paracelsus Medical University Salzburg Salzburg Austria
- Thomas Melchardt
- Third Medical Department Paracelsus Medical University Salzburg Salzburg Austria
- Petra Obrtlíková
- First Faculty of Medicine Charles University in Prague and General University Hospital in Prague Prague Czech Republic
- Lukáš Smolej
- Fourth Department of Internal Medicine ‐ Hematology, Faculty of Medicine in Hradec Králové University Hospital and Charles University in Prague Hradec Králové Czech Republic
- Tomáš Kozák
- Department of Internal Medicine ‐ Hematology University Hospital Kralovske Vinohrady Prague Czech Republic
- Michael Steurer
- Department of Internal Medicine V Medical University Innsbruck Innsbruck Austria
- Johannes Andel
- Internal Medicine II Hospital of Steyr Steyr Austria
- Sonja Burgstaller
- Department of Internal Medicine IV Klinikum Wels‐Grieskirchen GmbH Wels Austria
- Eva Mikušková
- Department of Hemato‐oncology 2 National Cancer Institute Bratislava Bratislava Slovakia
- Liana Gercheva
- Clinic of Hematology University Hospital St Marina Varna Varna Bulgaria
- Thomas Nösslinger
- Third Medical Department for Hematology and Oncology Hanusch Krankenhaus der Wiener Gebietskrankenkasse Vienna Austria
- Tomáš Papajík
- Department of Hemato‐oncology University Hospital Olomouc Olomouc Czech Republic
- Miriam Ladická
- Department of Clinical Oncology 1 National Cancer Institute Bratislava Bratislava Slovakia
- Michael Girschikofsky
- Interne Abteilung Ordensklinikum Linz GmbH Elisabethinen, Linz Austria
- Mikuláš Hrubiško
- Clinic of Hematology and Transfusiology Slovak Medical University, University Hospital Bratislava Bratislava Slovakia
- Ulrich Jäger
- Department of Medicine I, Division of Hematology and Hemostaeology Medical University Vienna Vienna Austria
- Daniela Voskova
- Department of Internal Medicine 3 Kepler Universitätsklinikum GmbH, Med Campus III. Linz Austria
- Martin Pecherstorfer
- Department of Internal Medicine 2 University Hospital Krems, Karl Landsteiner Private University of Health Sciences Krems Austria
- Eva Králiková
- Department of Hematology, FNsP F D Roosevelta Banská Bystrica Banska Bystrica Slovakia
- Christina Burcoveanu
- Clinic of Haematology Regional Institute of Oncology Iasi Iasi Romania
- Emil Spasov
- Clinic of Hematology UMHAT St George and Medical University Plovdiv Plovdiv Bulgaria
- Andreas Petzer
- Innere Medizin I, Ordensklinikum Linz GmbH Linz Austria
- Georgi Mihaylov
- Hematological Clinic NSHATHD Sofia, Queen Joanna University Hospital Sofia Bulgaria
- Julian Raynov
- Clinic of Medical Hematology Military Medical Academy Sofia Sofia Bulgaria
- Horst Oexle
- Innere Medizin Landeskrankenhaus Hall Hall in Tirol Austria
- August Zabernigg
- Innere Medizin II Bezirkskrankenhaus Kufstein Kufstein Austria
- Emília Flochová
- Department of Hematology and Transfusion University Hospital Martin Martin Slovakia
- Stanislav Palášthy
- Department of Clinical Hematology FNsP, J A Reimana Prešov Prešov Slovakia
- Olga Stehlíková
- Faculty of Medicine and CEITEC University Hospital Brno Brno Czech Republic
- Michael Doubek
- Faculty of Medicine and CEITEC University Hospital Brno Brno Czech Republic
- Petra Altenhofer
- Third Medical Department Paracelsus Medical University Salzburg Salzburg Austria
- Lukas Weiss
- Third Medical Department Paracelsus Medical University Salzburg Salzburg Austria
- Teresa Magnes
- Third Medical Department Paracelsus Medical University Salzburg Salzburg Austria
- Lisa Pleyer
- Third Medical Department Paracelsus Medical University Salzburg Salzburg Austria
- Anton Klingler
- Assign Data Management and Biostatistics GmbH Innsbruck Austria
- Jiří Mayer
- Faculty of Medicine and CEITEC University Hospital Brno Brno Czech Republic
- Richard Greil
- Third Medical Department Paracelsus Medical University Salzburg Salzburg Austria
- DOI
- https://doi.org/10.1002/cam4.1980
- Journal volume & issue
-
Vol. 8,
no. 4
pp. 1401 – 1405
Abstract
Abstract 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.
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