背景：体重指数（BMI）在淋巴瘤患者治疗结果中的作用存在争议。我们在研究霍奇金淋巴瘤（HL）患者使用ABVD类方案的疗效时发现，肥胖患者的疗效较差。为了更好地理解这一临床现象，我们评估了BMI对HL患者使用ABVD类化疗的疗效的影响。方法：这项回顾性队列研究评估了2016年11月至2023年3月在苏州大学附属第一医院接受ABVD类方案作为一线化疗的所有67名确诊HL患者的临床结果。通过比较不同BMI类别的基线患者特征和临床结果来进行评估。主要终点是总体反应率，定义为达到完全缓解或部分缓解的HL患者的比例。附加终点包括无进展生存期和总生存期。结果：HL患者的中位年龄为31岁。患者中，10.4％为肥胖，17.9％为超重。临时和最终反应评估显示总体反应率分别为98.5％和83.6％。在响应者与非响应者中，潜在不良预后因素（IPS风险因素）的患者比例没有显著差异。然而，与响应者相比，非响应者的平均BMI较高（p = 0.002）。高BMI患者的整体反应率的降低确实与进展无病生存期的缩短相关（p = 0.013）。与正常体重组相比，超重和肥胖组ABVD类方案的最低相对剂量显著较低（p < 0.001）。结论：我们的分析表明，超过80％的新诊断HL患者对ABVD类方案有反应。我们发现，在诊断时肥胖或超重与整体反应率较差相关，并且BMI是HL患者接受ABVD类方案治疗的独立危险因素。ABVD类方案的剂量降低导致高BMI组反应结果不一致。这些结果表明，新诊断的肥胖HL患者接受ABVD类方案需要个体化治疗。版权所有©2023 Hu, Ding, Zhang, Guo, Li, Jin, Qu and Xia.

Background: The role of body mass index (BMI) in the treatment outcomes of lymphoma patients is controversial. While investigating the efficacy of ABVD-like regimen in Hodgkin lymphoma (HL) patients, we observed that obese patients had poor responses. To better understand this clinical phenomenon, we evaluated the effect of BMI on responses to ABVD-like chemotherapy in HL patients. Methods: This retrospective cohort study evaluated the clinical outcomes of all 67 patients with confirmed HL who were treated at the First Affiliated Hospital of Soochow University from November 2016 to March 2023 with an ABVD-like regimen as first-line chemotherapy. Baseline patient characteristics and clinical outcomes were compared across different BMI categories. The primary end-point was the overall response rate defined as the proportion of the HL patients who achieved complete response or partial response. The additional end-points included progression-free survival and overall survival. Results: The median age of the HL patients was 31 years old. Of the patients, 10.4% were obese, and 17.9% patients were overweight. Interim and end-term response evaluations revealed overall response rates of 98.5% and 83.6%, respectively. The proportion of patients with potential poor prognostic factors (IPS risk factors) did not differ significantly in the responders versus non-responders. However, non-responders had a higher average BMI when compared with responders (p = 0.002). Poor overall response rates in higher BMI patients indeed manifested with shorter progression free survival (p = 0.013). The minimum relative dose of the ABVD-like regimen in the overweight and obese groups was significantly lower than in the normal weight group (p < 0.001). Conclusion: Our analyses show that >80% of newly-diagnosed HL patients responded to the ABVD-like regimen. We find that being obese or overweight at the time of diagnosis correlated with a poorer overall response rate and that BMI was an independent risk factor in HL patients treated with the ABVD-like regimen. Lower doses of ABVD-like regimen contributed to the discrepant findings of responses in the high BMI groups. These findings indicate that newly-diagnosed, obese HL patients receiving an ABVD-like regimen require personalized treatment.Copyright © 2023 Hu, Ding, Zhang, Guo, Li, Jin, Qu and Xia.