Objective: To explore the correlation between different body mass index (BMI) and prognosis of mantle cell lymphoma (MCL).
Methods: The clinical characteristics and biological indices of 108 patients with MCL treated in Fujian Medical University Union Hospital were retrospectively analyzed, and the effects of different BMI on overall survival (OS) and progression-free survival (PFS) were analyzed. The correlation between BMI and B symptoms, LDH and Ki-67 was further observed. Furthermore，the differences of BMI between Autologous peripheral blood stem cell transplantation(Auto-PBSCT) and conventional chemotherapy groups were explored.
Results: Among 108 patients, the median age at diagnosis was 59（25-79） years old, and the male to female ratio was 4.4∶1. 88.89% of patients with Ann Arbor staging III-IV, 63.89% with bone marrow involvement, and 49.07% with splenic infiltration. Patients with BMI ≥ 24 kg/m2 were divided into two groups: the high BMI group and the low BMI group. The 5-year PFS and OS of patients in the low BMI group were 31.9% and 47.0%, respectively, while those in the high BMI group were 64.6% and 68.7%, respectively. The incidence of death in the high BMI group was lower than that of the low BMI group (P＜0.01). In multivariate analysis, BMI was an independent predictor of PFS (HR=0.282; 95% CI: 0.122-0.651; P=0.003) and an independent predictor of OS (HR=0.299; 95% CI: 0.129-0.693; P=0.005). Also, patients with B symptoms had a lower BMI than those without B symptoms (P=0.01), but BMI had no effect on patients' LDH and Ki-67. The prognosis of 16 patients treated with Auto-PBSCT was significantly better than that of the conventional chemotherapy group. There was no significant difference in BMI between Auto-PBSCT group and conventional chemotherapy group.
Conclusion: BMI is an independent prognostic factor for PFS and OS in MCL, and may be influenced by the effect of B symptoms on BMI.
题目: 体质指数对套细胞淋巴瘤预后的影响.
目的: 探讨不同的体质指数（BMI）与套细胞淋巴瘤（MCL）预后的相关性.
方法: 回顾性分析福建医科大学附属协和医院收治的108例套细胞淋巴瘤患者的临床特征、生物学指标，分析不同的BMI对MCL患者总生存期（OS）和无进展生存期（PFS）的影响。进一步观察BMI与B症状、LDH及Ki-67指数的相关性，以及BMI在自体外周血造血干细胞移植（Auto-PBSCT）和常规化疗组中的差异.
结果: 108例患者确诊时中位年龄59（25-79）岁，男女比例是4.4∶1。Ann Arbor 分期Ⅲ-Ⅳ期患者占88.89%，骨髓累及者占63.89%，脾脏浸润者占49.07%。以BMI≥24 kg/m2为临界值将患者分为高BMI组和低BMI组两组。低BMI组的5年PFS和OS率分别为31.9%和47.0%,高BMI组的5年PFS和OS率分别为64.6%和68.7%。与低BMI组相比，高BMI组的死亡发生率更低（P＜0.01）。在多变量分析中，BMI是PFS的独立预测因素（HR＝0.282；95%CI： 0.122-0.651; P=0.003），也是OS的独立预测因素（HR＝0.299；95%CI： 0.129-0.693; P=0.005）。同时，存在B症状的患者的BMI低于无B症状的患者（P=0.01），但BMI对患者LDH和Ki-67没有影响。16例患者行Auto-PBSCT，且预后较常规化疗组明显好转，BMI在Auto-PBSCT组和常规化疗组未见明显差异.
结论: BMI是套细胞淋巴瘤患者PFS和OS的独立预后因素，可能受B症状对BMI的影响.
Keywords: B symptoms; BMI; mantle cell lymphoma; prognostic factors.