Jia Yi Tan, Yong Hao Yeo, Hermon Kha Kin Wong, Shatha Elemian, Marwa Mir, Qi Xuan Ang, Arya Mariam Roy, Daniel Ezekwudo, Hamid S Shaaban
{"title":"Impact of Obesity on Patients with Diffuse Large B-Cell Lymphoma Receiving Chimeric Antigen Receptor T-Cell Therapy.","authors":"Jia Yi Tan, Yong Hao Yeo, Hermon Kha Kin Wong, Shatha Elemian, Marwa Mir, Qi Xuan Ang, Arya Mariam Roy, Daniel Ezekwudo, Hamid S Shaaban","doi":"10.1159/000545933","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Obesity has been associated with poorer outcomes in conventional cancer therapies. However, its impact on chimeric antigen receptor (CAR) T-cell therapy for patients with diffuse large B-cell lymphoma (DLBCL) remains unclear. This study aims to evaluate how obesity affects in-hospital outcomes in patients with DLBCL receiving CAR-T therapy.</p><p><strong>Methods: </strong>Using the National Readmission Database (NRD), we included adults' age ≥18 with DLBCL who received CAR-T therapy between 2018 and 2020. We performed propensity score matching (caliper of 0.2, 1:1 ratio) and adjusted the following confounding variables: age, comorbidities, and social factors including smoking, alcohol use, and illicit drug use. Data analysis was conducted using R studio software.</p><p><strong>Results: </strong>A total of 1,874 patients with DLBCL who received CAR-T therapy (9.1% with obesity and 90.9% without) were included in the study. After propensity score matching, there were 160 patients with obesity (50.0%, 59.7 ± 12.2 years of age, 41.9% female) and 160 patients without obesity (50.0%, 58.6 ± 13.0 years of age, 41.3% female). Patients with obesity had significantly higher rates of early mortality (10.6% vs. 4.4%, p = 0.03) and non-home discharge (18.8% vs. 8.1%, p = 0.01) compared to those without obesity. There were no significant differences in 30-day readmission (18.1% vs. 21.3%, p = 0.48).</p><p><strong>Conclusion: </strong>The rates of acute kidney injury, cardiac complications, leukopenia, neurotoxicity, pulmonary embolism, and infection were comparable between these two groups. Our findings underscore the need for tailored management strategies to improve outcomes following CAR-T therapy for patients with obesity.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-5"},"PeriodicalIF":1.8000,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000545933","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Obesity has been associated with poorer outcomes in conventional cancer therapies. However, its impact on chimeric antigen receptor (CAR) T-cell therapy for patients with diffuse large B-cell lymphoma (DLBCL) remains unclear. This study aims to evaluate how obesity affects in-hospital outcomes in patients with DLBCL receiving CAR-T therapy.
Methods: Using the National Readmission Database (NRD), we included adults' age ≥18 with DLBCL who received CAR-T therapy between 2018 and 2020. We performed propensity score matching (caliper of 0.2, 1:1 ratio) and adjusted the following confounding variables: age, comorbidities, and social factors including smoking, alcohol use, and illicit drug use. Data analysis was conducted using R studio software.
Results: A total of 1,874 patients with DLBCL who received CAR-T therapy (9.1% with obesity and 90.9% without) were included in the study. After propensity score matching, there were 160 patients with obesity (50.0%, 59.7 ± 12.2 years of age, 41.9% female) and 160 patients without obesity (50.0%, 58.6 ± 13.0 years of age, 41.3% female). Patients with obesity had significantly higher rates of early mortality (10.6% vs. 4.4%, p = 0.03) and non-home discharge (18.8% vs. 8.1%, p = 0.01) compared to those without obesity. There were no significant differences in 30-day readmission (18.1% vs. 21.3%, p = 0.48).
Conclusion: The rates of acute kidney injury, cardiac complications, leukopenia, neurotoxicity, pulmonary embolism, and infection were comparable between these two groups. Our findings underscore the need for tailored management strategies to improve outcomes following CAR-T therapy for patients with obesity.
期刊介绍:
Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.