Body composition of patients with neuroblastoma using computed tomography

IJpma, Irene; Lequin, Maarten H.; Nievelstein, Rutger A.J.; Fiocco, Marta; Tissing, Wim J. E.

doi:10.1002/pbc.29337

Cited by 7 publications

(16 citation statements)

References 15 publications

(36 reference statements)

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“…Similarly, previous studies using CT scans to examine changes in body composition have also not demonstrated a correlation between changes in BMI%ile and skeletal muscle 24,25 . Although these studies did not find a correlation between changes in anthropometric measurements such as BMI%ile or BSA and measures of adiposity (in contrast to the findings in our study), these differences may be attributable to heterogeneity in study populations or the methods used for adiposity assessment 18,24,25 . For example, the report by Joffe et al.…”

Section: Discussioncontrasting

confidence: 84%

“…Most studies reporting changes in body composition have examined BMI and predominantly focused on children with acute lymphoblastic leukemia (ALL), 13,14,28–30 with very few studies using imaging‐based body composition assessment across other childhood cancer diagnoses 18,24,25 . We expand on that literature by examining body composition in children, adolescents, and young adults with lymphoma and rhabdomyosarcoma and show that patients undergo a significant decline in SMD during the first few weeks of treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Total adipose tissue (TAT) area was obtained by computing the sum of SAT, IMAT, and VAT and used to calculate height‐adjusted TAT (hTAT [cm 2 /m 2 ] = TAT [cm 2 ]/patient height [m] 2 ). The methodology for measuring the body composition and computing these indices followed the software recommendations and has been used in several prior studies that have included children and adults 18,20–26 …”

Section: Methodsmentioning

confidence: 99%

“…Additionally, prolonged corticosteroid exposure in children with leukemia is known to promote adipose tissue gain, which potentially results in myosteatosis and affects SMD 17 . However, longitudinal changes in body composition have remained understudied 18 . Furthermore, the association between changes in body composition and chemotoxicity risk remains unknown.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of longitudinal changes in body composition of children with lymphoma and rhabdomyosarcoma

Wadhwa

Lim

Dai

et al. 2023

Cancer

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BackgroundStudies examining changes in skeletal muscle and adipose tissue during treatment for cancer in children, adolescents, and young adults and their effect on the risk of chemotherapy toxicity (chemotoxicity) are limited.MethodsAmong 78 patients with lymphoma (79.5%) and rhabdomyosarcoma (20.5%), changes were measured in skeletal muscle (skeletal muscle index [SMI]; skeletal muscle density [SMD]) and adipose tissue (height‐adjusted total adipose tissue [hTAT]) between baseline and first subsequent computed tomography scans at the third lumbar vertebral level by using commercially available software. Body mass index (BMI; operationalized as a percentile [BMI%ile]) and body surface area (BSA) were examined at each time point. The association of changes in body composition with chemotoxicities was examined by using linear regression.ResultsThe median age at cancer diagnosis of this cohort (62.8% male; 55.1% non‐Hispanic White) was 12.7 years (2.5–21.1 years). The median time between scans was 48 days (range, 8–207 days). By adjusting for demographics and disease characteristics, this study found that patients undergo a significant decline in SMD (β ± standard error [SE] = −4.1 ± 1.4; p < .01). No significant changes in SMI (β ± SE = −0.5 ± 1.0; p = .7), hTAT (β ± SE = 5.5 ± 3.9; p = .2), BMI% (β ± SE = 4.1 ± 4.8; p = .3), or BSA (β ± SE = −0.02 ± 0.01; p = .3) were observed. Decline in SMD (per Hounsfield unit) was associated with a greater proportion of chemotherapy cycles with grade ≥3 nonhematologic toxicity (β ± SE = 1.09 ± 0.51; p = .04).ConclusionsThis study shows that children, adolescents, and young adults with lymphoma and rhabdomyosarcoma undergo a decline in SMD early during treatment, which is associated with a risk of chemotoxicities. Future studies should focus on interventions designed at preventing the loss of muscle during treatment.Plain Language Summary We show that among children, adolescents, and young adults with lymphoma and rhabdomyosarcoma receiving chemotherapy, skeletal muscle density declines early during treatment. Additionally, a decline in skeletal muscle density is associated with a greater risk of nonhematologic chemotoxicities.

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Section: Discussioncontrasting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessment of longitudinal changes in body composition of children with lymphoma and rhabdomyosarcoma

Wadhwa

Lim

Dai

et al. 2023

Cancer

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“…[82][83][84][85] It is an evaluation that involves high cost and radiation exposure and usually requires special programs and clinicians to quantify the amount of muscle and/or fat. However, patients undergoing abdominal CT for the evaluation of other clinical situations (eg, oncologic patients) 93 can undergo a retrospective image analysis of the L3 midpoint vertebral region to estimate the muscle area, which reflects body muscle mass in healthy populations and could be used in patients who are critically ill, despite difficulties in transporting this type of patient (sedated, mechanical ventilation, etc). 87 We found a few studies in pediatric patients that included specific populations, such as children with coronavirus disease 2019, neuroblastoma, etc.…”

Section: Ctmentioning

confidence: 99%

Body composition in pediatric patients

Zamberlan,

Mazzoni,

Bonfim

et al. 2023

Nut in Clin Prac

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Undernutrition is highly prevalent in children who are critically ill and is associated with increased morbidity and mortality, including a higher risk of infection due to transitory immunological disorders, inadequate wound healing, reduced gut function, longer dependency on mechanical ventilation, and longer hospital stays compared with eutrophic children who are critically ill. Nutrition care studies have proposed that early interventions targeting nutrition assessment can prevent or minimize the complications of undernutrition. Stress promotes an acute inflammatory response mediated by cytokines, resulting in increased basal metabolism and nitrogen excretion and leading to muscle loss and changes in body composition. Therefore, the inclusion of body composition assessment is important in the evaluation of these patients because, in addition to the nutrition aspect, body composition seems to predict clinical prognosis. Several techniques can be used to assess body composition, such as arm measurements, calf circumference, grip strength, bioelectrical impedance analysis, and imaging examinations, including computed tomography and dual‐energy x‐ray absorptiometry. This review of available evidence suggests that arm measurements seem to be well‐established in assessing body composition in children who are critically ill, and that bioelectrical impedance analysis with phase angle, handgrip strength, calf circumference and ultrasound seem to be promising in this evaluation. However, further robust studies based on scientific evidence are necessary.

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Quantitative computed tomography analysis of body composition changes in paediatric patients with acute lymphoblastic leukaemia

Suwannaying,

Ong,

Dhaduk

et al. 2024

Br J Haematol

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SummaryChildren with acute lymphoblastic leukaemia (ALL) are at risk for obesity and cardiometabolic diseases. To gain insight into body composition changes among children with ALL, we assessed quantitative computed tomography (QCT) data for specific body compartments (subcutaneous adipose tissue [SAT], visceral adipose tissue [VAT], total adipose tissue [TAT], lean tissue [LT], LT/TAT and VAT/SAT at lumbar vertebrae L1 and L2) at diagnosis and at off‐therapy for 189 children with ALL and evaluated associations between body mass index (BMI) Z‐score and clinical characteristics. BMI Z‐score correlated positively with SAT, VAT and TAT and negatively with LT/TAT and VAT/SAT. At off‐therapy, BMI Z‐score, SAT, VAT and TAT values were higher than at diagnosis, but LT, LT/TAT and VAT/SAT were lower. Patients aged ≥10 years at diagnosis had higher SAT, VAT and TAT and lower LT and LT/TAT than patients aged 2.0–9.9 years. Female patients had lower LT and LT/TAT than male patients. Black patients had less VAT than White patients. QCT analysis showed increases in adipose tissue and decreases in LT during ALL therapy when BMI Z‐scores increased. Early dietary and physical therapy interventions should be considered, particularly for patients at risk for obesity.

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Body composition of patients with neuroblastoma using computed tomography

Cited by 7 publications

References 15 publications

Assessment of longitudinal changes in body composition of children with lymphoma and rhabdomyosarcoma

Assessment of longitudinal changes in body composition of children with lymphoma and rhabdomyosarcoma

Body composition in pediatric patients

Quantitative computed tomography analysis of body composition changes in paediatric patients with acute lymphoblastic leukaemia

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