Assessing the Prognostic Impact of Muscle Quantity and Quality and Fat Distribution in Diffuse Large B-Cell Lymphoma

A study published in Frontiers in Nutrition found that reduced muscle quality (SMD) and increased intermuscular fat (IMAT) are linked to poor outcomes in patients with diffuse large B-cell lymphoma (DLBCL).

In this study, researchers retrospectively assessed CT scans of 116 patients with DLBCL. The patient population was 48% female, and the median age was 64 years. The researchers then investigated the 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 were quantified at the level of the third lumbar vertebra (L3) and proximal thigh.

According to the results, low L3-SMD, but not low L3-SMI, was associated with early therapy termination (p = 0.028), shorter OS (hazard ratio [HR] = 6.29; 95% confidence interval [CI] = 2.17-18.26; p < 0.001), and shorter PFS (HR = 2.42; 95% CI = 1.26-4.65; p = 0.008). Moreover, the researchers observed, even after correction for sex, International Prognostic Index (IPI), BMI, and R-CHOP therapy (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone), that low L3-SMD remained correlated with lower OS (HR = 3.54; 95% CI = 1.10-11.40; p = 0.034) but not with PFS.

“Reduced muscle quality and increased intermuscular fat, 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,” the researchers concluded.