Prognostic Impact of Muscle Quantity and Quality and Fat Distribution in Diffuse Large B-Cell Lymphoma Patients
Open Access
- 7 May 2021
- journal article
- research article
- Published by Frontiers Media SA in Frontiers in Nutrition
Abstract
Baseline CT scans of 116 patients (48% female, median 64 years) with diffuse large B-cell lymphoma (DLBCL) were retrospectively reviewed to investigate the prognostic role of sarcopenia and fat compartment distributions on overall survival (OS), progression-free survival (PFS), and early therapy termination. Skeletal muscle index (SMI), skeletal muscle density (SMD), and intermuscular adipose tissue (IMAT) were quantified at the level of the third lumbar vertebra (L3) and proximal thigh (PT). Low L3-SMD, but not low L3-SMI, was associated with early therapy termination (p = 0.028), shorter OS (HR = 6.29; 95% CI = 2.17–18.26; p < 0.001), and shorter PFS (HR = 2.42; 95% CI = 1.26–4.65; p = 0.008). After correction for sex, International Prognostic Index (IPI), BMI, and R-CHOP therapy (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone), low L3-SMD remained associated with poor OS (HR = 3.54; 95% CI = 1.10–11.40; p = 0.034) but not with PFS. Increased PT-IMAT was prognostic for poor OS and PFS after correction for sex, IPI, BMI, and R-CHOP therapy (HR = 1.35; CI = 1.03–1.7; p = 0.03, and HR = 1.30; CI = 1.04–1.64; p = 0.024, respectively). Reduced muscle quality (SMD) and increased intermuscular fat (IMAT), rather than low muscle quantity (SMI), are associated with poor prognosis in DLBCL, when measured at the L3 level, and particularly at the level of the proximal thigh. The proximal thigh represents a novel radiological landmark to study body composition.This publication has 43 references indexed in Scilit:
- The role of sex and weight on rituximab clearance and serum elimination half-life in elderly patients with DLBCLBlood, 2012
- Sarcopenia as a Prognostic Factor among Patients with Stage III MelanomaAnnals of Surgical Oncology, 2011
- Body mass index and outcomes in patients receiving chemotherapy for intermediate-grade B-cell non-Hodgkin lymphomaLeukemia & Lymphoma, 2010
- Smoking, alcohol use, obesity, and overall survival from non‐Hodgkin lymphomaCancer, 2010
- Fotemustine plus etoposide, cytarabine and melphalan (FEAM) as a new conditioning regimen for lymphoma patients undergoing auto-SCT: a multicenter feasibility studyBone Marrow Transplantation, 2009
- A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine careApplied Physiology, Nutrition, and Metabolism, 2008
- Lymphoma incidence patterns by WHO subtype in the United States, 1992-2001Blood, 2006
- CHOP Chemotherapy plus Rituximab Compared with CHOP Alone in Elderly Patients with Diffuse Large-B-Cell LymphomaThe New England Journal of Medicine, 2002
- A note on quantifying follow-up in studies of failure timeControlled Clinical Trials, 1996
- A Predictive Model for Aggressive Non-Hodgkin's LymphomaThe New England Journal of Medicine, 1993