Underweight and severe obesity are associated with decreased survival in patients with multiple myeloma (MM), according to a study published online Jan. 12 in the Blood Cancer Journal.
Urvi A. Shah, M.D., from the Memorial Sloan Kettering Cancer Center in New York City, and colleagues assessed the impact of body mass index (BMI) on progression-free survival (PFS) and overall survival (OS) in patients with newly diagnosed MM. The analysis included data from 1,142 patients from the Multiple Myeloma Research Foundation CoMMpass registry.
The researchers found that both patients with underweight and severe obesity had lower median PFS and OS than patients with normal weight, overweight, and moderate obesity. Patients with underweight had a significantly higher risk for death in models associating PFS and OS with BMI (hazard ratio [HR], 2.32; 95 percent confidence interval [CI], 1.09 to 4.97). Patients with severe obesity tended to have a higher for risk of progression (HR, 1.29; 95 percent CI, 0.99 to 1.67) and death (HR, 1.43; 95 percent CI, 0.98 to 2.08) versus patients with normal BMI. OS worsened with higher comorbidities (three-year OS for Charlson Comorbidity Index [CCI] ≥5: 65 percent; CCI >2 to <5: 87 percent; CCI ≤2: 87 percent). Frailty was also significantly associated with worse OS (three-year OS for frail versus nonfrail: 70 versus 88 percent). When accounting for CCI, there was a trend toward decreased OS in the underweight group versus the normal-weight group (HR, 2.12; 95 percent CI, 0.99 to 4.53).
“Clinical research to understand if patients with extreme BMI may benefit from weight management strategies to improve outcomes may be of importance,” the authors write
Urvi A. Shah et al, Extreme body mass index and survival in newly diagnosed multiple myeloma patients, Blood Cancer Journal (2023). DOI: 10.1038/s41408-022-00782-7
Blood Cancer Journal
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