Body mass index (BMI) and obesity as a predictor of clinical outcome in patients with Hodgkin's lymphoma treated with AVBD.

Abstract

8063 Background: BMI and obesity have been associated with altered pharmacokinetics (PK)/ pharmacodynamics (PKD) or poorer clinical outcome in several solid tumor malignancies. The impact of BMI or obesity in the outcome of HL patients and how it relates to other prognostic indicators is largely unknown. We retrospectively investigated the effects of BMI on complete response rate (CRR), progression free survival (PFS) and overall survival (OS) in HL patients treated with AVBD at RPCI. Methods: HL patients were identified using the tumor registry and pharmacy database at our institution. Only patients treated between 2000 and 2009 with complete demographic, clinical (including weight and height) and pharmacological data were included in the analysis. Patients were divided based on their BMI into normal (BMI ≤24.9) vs. overweight (BMI ≥25) or normal vs. obese (BMI≥30). Differences in CRR, PFS and OSS were compared based on BMI category. Results: A total of 137 patients (76% Nodular sclerosis subtype) were included in the study. Median age was 33 yrs (F/M: 57/80). According to BMI, 48 were normal, 43 overweight, and 46 obese. Males were more likely to have BMI ≥25 (P=0.028). No differences in stage, B-symptoms, or bulky disease were seen between subgroups. The CRR to AVBD was 80.3% and did not correlate with BMI. Relapsed/refractory disease was observed in 23.4% of the pts. The PFS was lower in patients with BMI ≥ 25 than in normal weight patients (P=0.016). There was no significant difference in the OS between the BMI subgroups. Additional 100 pts have been identified and the cohort will be expanded. Conclusions: Our preliminary data suggests that BMI may be a predictor of PFS in patients with HL receiving standard doses of ABVD. It is possible that the PK or PKD of ABVD may be altered by patient's BMI leading to sub-therapeutic doses in the tumor bed and relapsed/refractory disease. The incorporation of PKD modeling into the multidisciplinary treatment of malignancies may improve clinical outcomes, including for HL patients. No significant financial relationships to disclose.