Abstract 12958: Prognostic Value of Body Composition for Predicting Venous Thromboembolism in Pediatric, Adolescent, and Young Adult Patients With Lymphoma

Abstract

Introduction: Body composition (BC) influences chemotherapy toxicity, surgical complication rates, and overall survival in cancer patients. While recent studies have shown the connection between BC and clinical outcomes in adult oncology populations, BC measures are still often overlooked in the pediatric, adolescent, and young adult (AYA) oncology populations. The objective of this study was to determine the effect of BC on the occurrence of venous thromboembolism (VTE) in pediatric and AYA patients with lymphoma. Methods: Skeletal muscle (SkM), subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT) volumes were manually segmented at vertebral level L3 from 5 consecutive axial CT images ( Fig. 1A ) acquired in a 5-year retrospective cohort of 78 patients with lymphoma (mean age = 13.3 ± 0.6 years). All CT images were acquired at initial staging of disease. Incidence of VTE, including deep vein thrombosis and pulmonary embolism, was evaluated for 12 months after diagnosis. Results and Conclusions: In the first 12 months after diagnosis, 26 of 88 patients (33%) had a VTE event. Patients with VTE had a significantly higher percent of SAT (p = 0.022) and lower percent of SkM (p = 0.036) compared to patients without VTE ( Fig. 1B ). Patients were stratified based on a SkM/SAT cut-off ratio of 0.963, determined using the Receiver-Operating-Characteristic Curve. Patients who were below this SkM/SAT cutoff ratio had a significantly higher probability for VTE in the first 12 months compared to patients who were above the cutoff (log-rank test, p < 0.005) ( Fig. 1C ). This cutoff ratio remained significant after correcting for lymphoma subtype, body mass index, age, and sex using the Cox Proportional-Hazards model. Standard-of-care CT imaging may offer a technique for evaluating BC and predicting outcomes such as VTE in pediatric and AYA patients, thereby offering personalized approaches to cancer care by guiding chemotherapy dosing and nutritional recommendations.