Aggressive lymphoma: cachexia shows sex-specific prognostic utility

  • Burkart M & al.
  • Br J Haematol
  • 2 Apr 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • In patients with aggressive lymphomas, cachexia offers different prognostic utility in men vs women and may be linked to specific metabolic and immune markers.

Why this matters

  • Cachexia affects 60%-80% of patients with cancer and is believed to be an anabolic state resulting from changes in metabolism supporting tumor proliferation/growth.

Study design

  • Study to investigate associations between cachexia and outcomes in 109 patients with aggressive B-cell non-Hodgkin lymphoma (B-NHL).
  • Funding: None disclosed.

Key results

  • In males:
    • 5.4 months median PFS with sarcopenia vs 72.3 months without (P<.0005>
    • 30.2 months median OS with sarcopenia vs not reached (NR) without (P=.02).
    • 21.6 months median OS with adipopenia vs NR without (P=.036).
  • In females:
    • Sarcopenia yielded nonsignificant trend for extended OS (P=.078).
    • No significant association between adipopenia and reduced OS (P=.118).
  • After adjusting for sex in the prospective cohort (n=14), positive correlation between skeletal muscle index and markers of:
    • Glucose metabolism pathway:
      • Insulin-like growth factor proteins 6 and 1: P=.04 and .02, respectively.
    • Inflammatory pathway:
      • Lymphotoxin-like inducible protein that competes with glycoprotein D for herpesvirus entry on T-cells (LIGHT): P=.005.
    • Energy expenditure: P=.004.

Limitations

  • Limited sample size.

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