Obesity is a positive chronic imbalance between energy intake and expenditure mediated through leptin (LEP) signaling pathway; its incidence has increased dramatically throughout the last decades. Obesity is linked to a general increase in the incidence and mortality of cancer, including non-Hodgkin's lymphoma (NHL). Also, associations between polymorphisms in LEP and LEP receptor (LEPR) genes and non-Hodgkin's lymphomas have been reported. But, whether obesity and leptin level can change the response of NHL to chemotherapy is less well-studied. Thus, this study was conducted aiming at evaluating the impact of body mass index (BMI) and serum leptin level on the response of Egyptian NHL patients to chemotherapy. Patients and methods: 100 adult patients with recently-diagnosed NHLs were included. For each patient, thorough medical history was obtained and complete physical examination was performed. Body mass index (BMI) was determined based on patient's height and weight. The following investigations were performed: laboratory investigations including complete blood count (CBC), serum levels of lactate dehydrogenase (LDH), liver enzymes, bilirubin, albumin, creatinine, uric acid, and lipid profiles, and serum leptin level; imaging studies including pelvi-abdominal ultrasonography, computerized tomography (CT) scans and positron-emission tomography (PET); and pathologic examination of biopsy samples obtained from the affected lesions. Based on the pathologic NHL subtypes, appropriate chemotherapy regimens were given, including R-CHOP, CHOP, CVP, or FC regimen, for 6 cycles. Then, the patients were re-assessed by pan CT scans to determine the response to chemotherapy. Results: Significant positive correlation was observed between the values of BMI and the serum levels of leptin. The BMI and serum leptin levels were significantly higher in female NHL patients compared to male patients. Serum leptin level was significantly higher in NHL patients presented with B symptoms compared to those without B symptoms. Both BMI and serum leptin levels were significantly higher in patients with stage-4 disease compared to those with stage-1. Serum leptin level was significantly higher in patients with DLBCL (diffuse large B-cell lymphoma) and mantel cell lymphoma. Patients who showed regressive response had significantly lower BMI and leptin level compared to patients who did not respond and showed progressive disease. Conclusion and recommendation: Obesity, increased BMI and elevated serum leptin level had a worse impact on response of NHL patients to chemotherapy. Further studies are recommended to evaluate whether the response of various NHL pathologic subtypes could be affected by BMI and leptin levels. |
