The geriatric syndrome of sarcopenia impacts allogeneic hematopoietic cell transplantation outcomes in older lymphoma patients

Lin, Richard J.; Michaud, Laure; Lobaugh, Stephanie; Nakajima, Reiko; Mauguen, Audrey; Elko, Theresa A; Ruiz, Josel D.; Maloy, Molly; Sauter, Craig S.; Dahi, Parastoo B.; Perales, Miguel-Ángel; Shah, Gunjan L.; Flores, Nerea Castillo; Sanchez-Escamilla, Míriam; Tomas, Ana Alarcón; Segundo, Lucrecia Yáñez San; Cho, Christina; Politikos, Ioannis; Kim, Soo Jung; Korc‐Grodzicki, Beatriz; Devlin, Sean M.; Scordo, Michael; Schöder, Heiko; Giralt, Sergío; Hamlin, Paul A.

doi:10.1080/10428194.2020.1742909

Cited by 10 publications

(5 citation statements)

References 40 publications

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“…Our ndings support the current literature suggesting that in hematological malignancies, high VAT is protective 10 and that muscle measures such as sarcopenia and myosteatosis had an unclear impact on overall survival, with some studies suggesting that sarcopenia did not impact hematological malignancies 8 while another retrospective trial showed that patients with sarcopenia had worse OS after allogeneic stem cell transplant 17 . The protective role of high VAT was also con rmed in older patients with diffuse large B cell lymphoma treated with R-CHOP or mini-RCHOP chemotherapy 18 and in older patients with acute myelogenous leukemia 19,20 .…”

Section: Discussionsupporting

confidence: 88%

The Association of Body Composition and Outcomes Following Autologous Hematopoietic Stem Cell Transplantation in Patients with Non-Hodgkin Lymphoma

Aleixo

Wei

Chen

et al. 2023

Preprint

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Recently there has been a growing interest in evaluating body composition as a marker for prognosis in cancer patients. The association of body composition parameters and outcomes has not been deeply investigated in patients with autologous hematopoietic stem cell transplantation (HSCT) recipients with non-Hodgkin lymphoma (NHL). Methods We conducted a retrospective cohort study of 264 NHL patients who received autologous HSCT. Pre-HSCT abdominal CT scans at the levels of L3 were assessed for body composition measures. We evaluated sarcopenia, myosteatosis, high Visceral Adipose Tissue and high visceral adipose tissue density. Using multivariable Cox proportional regression, we analyzed the association of clinical and transplant-related characteristics with overall Survival (OS), relapse-free survival (RFS), and non-relapse mortality (NRM). Results In a multivariate regression model, patients with higher VATD had worse OS (HR 1.78; 95% confidence intervals CI 1.08–2.95, P = 0.02) and worse NRM (HR 2.31 95%CI 1.08–4.95 p = 0.02) than with lower VATD. Patients with lower levels of VAT also had worse RFS (HR 1.49 95% CI 1.03–2.15 p = 0.03). Sarcopenia and myosteatosis were not associated with outcomes. Conclusion High pre-transplant VATD was associated with lower OS and higher NRM, and low pre-transplant VAT was associated with worse RFS in patients with NHL undergoing autologous HSCT.

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Section: Discussionsupporting

confidence: 88%

The Association of Body Composition and Outcomes Following Autologous Hematopoietic Stem Cell Transplantation in Patients with Non-Hodgkin Lymphoma

Aleixo

Wei

Chen

et al. 2023

Preprint

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“…This diminution continues but less strongly until the end of first-line treatment. The reduction of SMA and SMI and consequent sarcopenia gain during the course of treatment was already demonstrated by other studies [ 10 , 11 , 12 , 13 ]. Compared to these studies where the rate of sarcopenia at baseline ranged from 27% to 55%, the rate of sarcopenia in our population was higher with 66% at baseline.…”

Section: Discussionsupporting

confidence: 64%

“…This is due to the advanced age (>65 years) of our patients. The only paper specific to older lymphoma [ 12 ] reported a rate of sarcopenia of 55%, but they included many lymphoma variants (only eight HL) and the age criterion of inclusion was superior to 50 years, lower than us. For these reasons, a direct comparison with other studies seems to be difficult and excessive.…”

Section: Discussionmentioning

confidence: 79%

“…However, a parameter not well evaluated is the evolution of body composition during treatment in oncological patients. Initial studies reported body composition changes occurring after therapy in lymphoma, such as hematopoietic cell transplantation [ 10 , 11 , 12 ] or systemic therapy (chemotherapy) [ 13 ], but with controversial results. Thus, the first aim of this retrospective study was to describe the longitudinal body changes in terms of muscle and adipose areas measured by baseline, interim, and end of treatment [ 18 F]FDG PET/CT in elderly patients affected by HL undergoing chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal Body Composition Changes Detected by [18F]FDG PET/CT during and after Chemotherapy and Their Prognostic Role in Elderly Hodgkin Lymphoma

Albano

Dondi

Treglia

et al. 2022

Cancers

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The aim of this retrospective study was to investigate the longitudinal body changes in terms of muscle and adipose areas and their prognostic role in elderly (>65 years) patients affected by Hodgkin lymphoma (HL). Skeletal muscle area (SMA), skeletal muscle index (SMI), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), intramuscular adipose tissue (IMAT), and total dispose tissue (TAT) were measured using the computed tomography (CT) of fluorine-18-fluorodeoxyglucose positron emission tomography/CT ([18F]FDG PET/CT) in 88 patients who undertook baseline, interim (after two cycles of chemotherapy), and end-of-treatment (after 6 cycles of chemotherapy) PET/CT scans. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were measured at pre-treatment PET/CT. Metabolic response applying Deauville score was evaluated at interim and end-of-treatment PET/CT. Survival curves, such as progression free survival (PFS) and overall survival (OS), were calculated for the whole population. Fifty-eight (66%) patients had sarcopenia at baseline and sarcopenia rate increased at interim scan with 68 (77%) cases and at end-of-treatment scan with 73 (83%) cases. Muscular areas (SMA and SMI) declined significantly during the treatment (p < 0.001), decreasing from baseline by 5% and 7% at interim and end-of-treatment evaluation, respectively. Instead, VAT, SAT, IMAT, and TAT increased significantly over this time (p < 0.001). Sarcopenia was significantly related with comprehensive geriatric assessment. PET/CT response at interim and end-of-treatment, MTV, TLG, and baseline sarcopenia were independent prognostic factors for PFS. Instead, metabolic response at interim and end-of-treatment PET, baseline sarcopenia, ΔSMI at interim, and ΔSMI at end-of-treatment for OS were independent prognostic factors.

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“…Among hematologic malignancies, sarcopenia has been mostly evaluated in patients with lymphoma, and to a lesser extent in patients with leukemia. While some studies have found sarcopenia to be associated with inferior outcomes with chemoimmunotherapy [ 8 – 13 ] and transplant [ 14 – 17 ], others have shown no prognostic impact [ 18 ], or even a protective role of sarcopenia [ 19 ]. These discordant results are, at least in part, explained by variability in the populations and subgroups studied and differences in the thresholds used to define sarcopenia [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Muscle and fat composition in patients with newly diagnosed multiple myeloma

Abdallah,

Nagayama,

Takahashi

et al. 2023

Blood Cancer J.

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Measures of muscle and adipose tissue mass have been associated with outcomes in several malignancies, but studies in multiple myeloma (MM) are inconsistent. The aim of this study was to evaluate the association between muscle and fat areas and radiodensity, and overall survival (OS) in patients with newly diagnosed MM. We included 341 patients diagnosed with MM from 2010–2019 who had an 18F-fluorodeoxyglucose positron emission tomography/computed tomography at diagnosis. A cross-sectional image at the third lumbar vertebrae was segmented into muscle and fat components. Median follow up was 5.7 years. There was no association between sarcopenia and baseline disease characteristics or OS. Low muscle radiodensity was associated with higher disease stage, anemia, and renal failure. OS was 5.6 vs. 9.0 years in patients with muscle radiodensity in the lower vs. middle/upper tertiles, respectively (P = 0.02). High subcutaneous adipose tissue (SAT) radiodensity was associated with higher stage, anemia, thrombocytopenia, hypercalcemia, renal failure, and high LDH. OS was 5.4 years vs. not reached in patients with SAT radiodensity in the upper vs. middle/lower tertiles, respectively (P = 0.001). In conclusion, sarcopenia was not associated with OS in MM patients. High SAT radiodensity and low muscle radiodensity were associated with advanced disease stage and adverse laboratory characteristics.

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The geriatric syndrome of sarcopenia impacts allogeneic hematopoietic cell transplantation outcomes in older lymphoma patients

Cited by 10 publications

References 40 publications

The Association of Body Composition and Outcomes Following Autologous Hematopoietic Stem Cell Transplantation in Patients with Non-Hodgkin Lymphoma

The Association of Body Composition and Outcomes Following Autologous Hematopoietic Stem Cell Transplantation in Patients with Non-Hodgkin Lymphoma

Longitudinal Body Composition Changes Detected by [18F]FDG PET/CT during and after Chemotherapy and Their Prognostic Role in Elderly Hodgkin Lymphoma

Muscle and fat composition in patients with newly diagnosed multiple myeloma

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