Impact of Obesity on Patients with Diffuse Large B-Cell Lymphoma Receiving Chimeric Antigen Receptor T-Cell Therapy

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.

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.

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).

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.