Prognostic Role of "Radiological" Sarcopenia in Lymphoma: A Systematic Review

Albano, Domenico; Dondi, Francesco; Ravanelli, Marco; Tucci, Alessandra; Farina, Davide; Giubbini, Raffaele; Treglia, Giorgio; Bertagna, Francesco

doi:10.1016/j.clml.2021.11.006

Cited by 11 publications

(13 citation statements)

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“…The clinical meaning of the sarcopenia has already been investigated and it is emerging as a promising tool for predicting the survival and treatment response [ 20 , 21 , 22 , 23 ]. However, in lymphoma patients, its usefulness is not yet clear because controversial evidence is available and the studies present are based specifically on HL and DLBCL [ 12 , 24 ], while for the other lymphoma histotyopes, specific studies are lacking. For this reason, we aimed to analyze patients affected by MCL, which is a lymphoma typical in advanced age.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the lack of consensus for optimal cut-off levels to define sarcopenia in lymphoma patients, and especially in MCL, we derived specific values for our population using ROC curve analysis. Many different thresholds have been proposed [ 12 ], specific for gender, BMI, ethnicity and geographic regions. Thus, it is hazardous to consider a unique threshold validated in other lymphoma variants.…”

Section: Discussionmentioning

confidence: 99%

“…Sarcopenia can be considered a multi-factorial syndrome, defined by a progressive and generalized loss of strength and skeletal muscle mass, which may increase the risk of adverse events (until death) and reduce the quality of life [ 11 ]. In HL and diffuse large B cell lymphoma (DLBCL), the sarcopenia estimated by CT (low-dose CT of PET or high-dose CT) has been shown to be an independent prognostic factor [ 12 , 13 ], while in MCL, these analyses are anecdotal with low numbers [ 14 , 15 ] of patients included and mixed with other lymphoma histotypes [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Role of Pre-Treatment Metabolic Parameters and Sarcopenia Derived by 2-[18F]-FDG PET/CT in Elderly Mantle Cell Lymphoma

Albano

Pasinetti

Dondi

et al. 2022

JCM

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The goal of this retrospective study was to analyze and compare the prognostic role of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (2-[18F]-FDG PET/CT) features and sarcopenia, estimated by CT of PET in elderly (≥65 years) Mantle Cell Lymphoma (MCL). We recruited 53 patients, who underwent pre-treatment 2-[18F]-FDG PET/CT and end-of-treatment PET/CT, and the main semiquantitative parameters were calculated. Sarcopenia was measured as skeletal muscle index (SMI, cm2/m2) and derived by low-dose PET/CT images at the L3 level. Specific cut-offs for SMI were calculated by receiver operator curve and divided by gender. Metabolic response was evaluated at end-of-treatment PET/CT, applying the Deauville score. Progression Free Survival (PFS) and Overall Survival (OS) were calculated for the whole population and for different subgroups, defined as per different sarcopenia cut-off levels. The specific cut-offs to define sarcopenia were 53 cm2/m2 for male and 45.6 cm2/m2 for female. Thirty-two (60%) patients were defined as sarcopenic. The 3-year and 5-year PFS rates were 29% and 23%, while the 3-year and 5-year OS rates were 43% and 33%. Metabolic response, total metabolic tumor volume (tMTV), total lesion glycolysis (tTLG) and sarcopenia were independent prognostic factors for PFS. Considering OS, no variable was significantly associated. Combination between PET features and sarcopenia may help to predict PFS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic Role of Pre-Treatment Metabolic Parameters and Sarcopenia Derived by 2-[18F]-FDG PET/CT in Elderly Mantle Cell Lymphoma

Albano

Pasinetti

Dondi

et al. 2022

JCM

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“…Then, for each patient, SMA was normalized for the height to derive the skeletal muscle index (SMI) (cm 2 /m 2 ). For the definition of sarcopenia, we applied gender-specific cut-offs of SMI of 39 cm 2 /m 2 for females and 55 cm 2 /m 2 for male patients, as suggested in the literature [ 6 ].…”

Section: Methodsmentioning

confidence: 99%

“…Particularly, Deauville scores measured at interim and end-of-treatment PET and several semiquantitative baseline PET/CT parameters, such as metabolic tumor value (MTV) and total lesion glycolysis (TLG), are significantly related to survival [ 4 , 5 ]. Besides these variables, sarcopenia also seems to have a prognostic impact for lymphoma [ 6 ]. Sarcopenia is considered a syndrome characterized by a progressive and diffuse loss of skeletal muscle mass and strength with a high risk of adverse events, e.g., physical disability, poor quality of life, and even exitus [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

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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Quantitative Ultrasound Parameters as Predictors of Chemotherapy Toxicity in Lymphoma

Sun,

Huang,

Shao

et al. 2024

J of Ultrasound Medicine

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ObjectivesThe aim of this study was to use quantitative ultrasound (QUS) parameters to assess the muscle mass and quality in patients with lymphoma. Additionally, the study aimed to investigate the relationship between these QUS parameters and post‐chemotherapy myelosuppression.MethodsThe study cohort comprised 202 patients diagnosed with lymphoma (105 males, 97 females; mean age 57.0 ± 14.9 years). The skeletal muscle index (SMI) and mean skeletal muscle density (SMD) were measured on CT and used as the gold standards to evaluate low skeletal muscle mass and quality. The muscle thickness (MT) of the forearm flexor and extensor muscles was measured in both the relaxed and contracted states, while the normalized non‐linear parameter B/A (MusQBOX.NLP) and normalized mean intensity (MusQBOX.NMI) were extracted from retained ultrasound radiofrequency signals. The correlations between the QUS parameters and grip strength were assessed. Models were constructed using these QUS parameters to predict low SMI and SMD, and to evaluate whether these factors were independently associated with post‐chemotherapy myelosuppression.ResultsThe MT in both the relaxed and contracted states exhibited the strongest correlations with grip strength, while the MusQBOX.NLP and MusQBOX.NMI were only weakly correlated with grip strength. Models incorporating QUS parameters to predict low SMI and SMD achieved high area under the receiver operating characteristic curve values. The MT, MusQBOX.NLP, and MusQBOX.NMI were independent factors associated with post‐chemotherapy myelosuppression.ConclusionsQUS parameters show promise in characterizing muscle strength, mass, and quality. They are also independent factors influencing post‐chemotherapy myelosuppression.

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Prognostic Role of "Radiological" Sarcopenia in Lymphoma: A Systematic Review

Cited by 11 publications

References 50 publications

Prognostic Role of Pre-Treatment Metabolic Parameters and Sarcopenia Derived by 2-[18F]-FDG PET/CT in Elderly Mantle Cell Lymphoma

Prognostic Role of Pre-Treatment Metabolic Parameters and Sarcopenia Derived by 2-[18F]-FDG PET/CT in Elderly Mantle Cell Lymphoma

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

Quantitative Ultrasound Parameters as Predictors of Chemotherapy Toxicity in Lymphoma

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