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. 2013;18(10):1074-9.
doi: 10.1634/theoncologist.2013-0015. Epub 2013 Sep 18.

Influence of body mass index on survival in veterans with multiple myeloma

Tracey S Beason  1 , Su-Hsin Chang, Kristen M Sanfilippo, Suhong Luo, Graham A Colditz, Ravi Vij, Michael H Tomasson, John F Dipersio, Keith Stockerl-Goldstein, Arun Ganti, Tanya Wildes, Kenneth R Carson
Affiliations

Influence of body mass index on survival in veterans with multiple myeloma

Tracey S Beason et al. Oncologist. 2013.

Abstract

Purpose: We investigated the association between body mass index (BMI) at the time of multiple myeloma (MM) diagnosis and overall survival in a cohort of patients within the Veterans Health Administration system. We also evaluated the association between weight loss in the year prior to diagnosis and survival.

Patients and methods: Prospective analysis was performed on a retrospectively assembled cohort of 2,968 U.S. veterans diagnosed and treated for MM between September 1, 1999, and September 30, 2009, with follow-up information through October 22, 2011. Cox modeling controlling for patient- and disease-related prognostic variables was used to analyze the data.

Results: Underweight patients (BMI <18.5 kg/m2) had increased mortality, whereas patients who were overweight (BMI 25-29.9 kg/m2) and obese (BMI ≥30 kg/m2) had lower mortality compared with healthy-weight patients (BMI 18.5-24.9 kg/m2). Weight loss ≥10% of baseline in the year before diagnosis was also associated with increased mortality and made the association between increased BMI and survival nonsignificant.

Conclusion: Disease-related weight loss may be an important and heretofore unknown indicator of poor prognosis in MM. Assessment of weight loss prior to MM diagnosis should become a standard component of the clinical history in patients with newly diagnosed MM. Further research may identify relationships between disease-related weight loss and currently used prognostic factors in MM, further defining the role of this clinical factor in prognostic stratification.

Keywords: Body mass index; Mortality; Multiple myeloma; Obesity; Overweight; Survival.

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Conflict of interest statement

Disclosures of potential conflicts of interest may be found at the end of this article.

Figures

Figure 1.
Figure 1.
Consort diagram for multiple myeloma cases diagnosed in U.S. veterans between 1998 and 2009.
Figure 2.
Figure 2.
Kaplan-Meier curves of U.S. veterans diagnosed with multiple myeloma from 1998 to 2009, body mass index at diagnosis and overall survival (n = 2,968). Log-rank p < .001. Abbreviation: BMI, body mass index.
See this image and copyright information in PMC

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