Impact of body weight changes on adverse events and treatment outcomes during R-CHOP chemotherapy for non-Hodgkin's...

We investigated whether weight fluctuations during rituximab plus cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisolone (R-CHOP) chemotherapy affect adverse events and outcomes in patients with non-Hodgkin lymphoma (NHL).

This single-center retrospective study included 151 patients who received R-CHOP between April 2015 and March 2023 and grouped them by first-cycle weight loss ≥ 5% (Group 1) or < 5% (Group 2). Patient characteristics, adverse events, and outcomes were assessed using survival analysis and Cox regression models.

Of the 151 patients, Group 1 (35.1%) showed higher rates of selected toxicities-particularly fatigue (83.0% vs. 68.4%, p = 0.04) and anemia (43.4% vs. 27.6%, p = 0.04)-than Group 2; other toxicities were non-significant on nominal, unadjusted tests. Early weight loss correlated with further weight changes (cycles 2-5: r = 0.61-0.78, p < 0.01) and was associated with shorter recurrence-free survival (RFS; HR: 1.844, p = 0.048). Female sex and an mGPS of 2 independently predicted early weight loss (adjusted OR [95% CI]: female sex: 2.98 [1.43-6.20]; p = 0.004; mGPS of 2: 3.14 [1.39-7.07], p = 0.006). In multivariable models, only high IPI remained independently associated with worse RFS (p = 0.010).

Early weight loss during R-CHOP correlated with higher toxicity events and was univariably associated with shorter RFS; IPI was the key independent predictor of RFS after adjustment. Monitoring weight fluctuations potentially facilitates the identification of vulnerable patients and could guide timely interventions. These findings are exploratory and based on nominal, unadjusted comparisons; prospective confirmation is required.