在确定患有高级别成熟 B 细胞非霍奇金淋巴瘤 (HG B-NHL) 的儿童和青少年的预后因素方面进展甚微。基于体重指数（BMI）在癌症中的重要作用，本研究探讨BMI对HG B-NHL患者预后的影响。入组年龄<18岁的初诊HG B-NHL患者。根据儿童和青少年生长标准，将患者分为BMI正常组、超重组、肥胖组和消瘦组。本研究共纳入435名患者。 BMI 正常组、超重组、肥胖组和消瘦组分别有 329 例（75.6%）、46 例（10.6%）、13 例（3.0%）和 47 例（10.8%）患者。整个队列的无事件生存率和总生存率分别为 89.3% 和 92.4%。 BMI 肥胖患者的 5 年无事件生存率低于 BMI 超重患者（76.2% vs. 95.6%，p = .04）。 BMI 消瘦患者的 5 年总生存率低于 BMI 正常患者（84.5% vs. 93.1%，p = .04）或超重患者（84.5% vs. 97.7%，p = .03）。 Cox 多变量分析显示，诊断时肥胖或消瘦的 BMI 与死亡风险增加相关（p = 0.04；HR，2.26），并被确定为儿科 HG B-NHL 的独立不良预后因素。诊断时肥胖或消瘦的 BMI与儿童 HG B-NHL 的不良预后相关，可用于风险分层。© 2024 美国癌症协会。

Little progress has been made in determining the prognostic factors for children and adolescents with high-grade mature B-cell non-Hodgkin lymphoma (HG B-NHL). Based on the important role of body mass index (BMI) in cancer, this study explored the effect of BMI on the prognosis of patients with HG B-NHL.Patients aged <18 years with newly diagnosed HG B-NHL were enrolled. Patients were divided into normal, overweight, obese, and emaciated BMI groups according to the growth criteria for children and adolescents.In total, 435 patients were enrolled in this study. There were 329 (75.6%), 46 (10.6%), 13 (3.0%), and 47 (10.8%) patients stratified into the normal, overweight, obese, and emaciated BMI groups, respectively. The event-free survival and overall survival rates of the entire cohort were 89.3% and 92.4%, respectively. The 5-year event-free survival rate for the patients with obese BMI was worse than those with overweight BMI (76.2% vs. 95.6%, p = .04). The 5-year overall survival rate for the patients with emaciated BMI was worse than those with normal (84.5% vs. 93.1%, p = .04) or overweight BMI (84.5% vs. 97.7%, p = .03). Cox multivariate analysis showed that obese or emaciated BMI at diagnosis was associated with an increased risk of death (p = 0.04; HR, 2.26) and was identified as an independent adverse prognostic factor in pediatric HG B-NHL.Obese or emaciated BMI at diagnosis is associated with poor prognosis in pediatric HG B-NHL and can be used for risk stratification.© 2024 American Cancer Society.