title: Sarcopenia is an independent prognostic factor in elderly patients with diffuse large B-cell lymphoma treated with immunochemotherapy.
abstract: Approximately 25-35% of patients with diffuse large B-cell lymphoma (DLBCL) are older than 70 years. The aim of this study was to investigate the prognostic impact of depletion of skeletal muscle (sarcopenia) in elderly patients with DLBCL. This retrospective analysis included 82 patients with DLBCL older than 70 years and treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, Oncovin, prednisone) or R-miniCHOP. Sarcopenia was measured by the analysis of stored computed tomography (CT) images at the L3 level at baseline. The surface of the muscular tissues was selected according to the CT Hounsfield unit. This value was normalized for stature in order to calculate the lumbar L3 skeletal muscle index (LSMI, in cm(2)/m(2)). The mean age of the population was 78 years. According to the defined cut-offs for LSMI, 45 patients with DLBCL were considered sarcopenic. Sarcopenic patients displayed a higher revised International Prognostic Index (R-IPI) compared with patients without sarcopenia, and were older, with a mean age of 80 years and 77 years, respectively (p = 0.006). With a median follow-up of 39 months, the 2-year overall survival in the sarcopenic population was 46% compared with 84% in the non-sarcopenic group (HR = 3.22; 95% CI = 1.73-5.98; p = 0.0002). In a multivariate analysis, sarcopenia remained predictive of outcome (p = 0.005). Sarcopenia is a relevant and predictive factor in elderly patients with DLBCL treated with rituximab plus chemotherapy.
authors.affiliation: Department of Hematology.
authors.forename: Hélène
authors.initials: H
authors.lastname: Lanic
authors.forename: Jerôme
authors.initials: J
authors.lastname: Kraut-Tauzia
authors.forename: Romain
authors.initials: R
authors.lastname: Modzelewski
authors.forename: Florian
authors.initials: F
authors.lastname: Clatot
authors.forename: Sylvain
authors.initials: S
authors.lastname: Mareschal
authors.forename: Jean Michel
authors.initials: JM
authors.lastname: Picquenot
authors.forename: Aspasia
authors.initials: A
authors.lastname: Stamatoullas
authors.forename: Stéphane
authors.initials: S
authors.lastname: Leprêtre
authors.forename: Hervé
authors.initials: H
authors.lastname: Tilly
authors.forename: Fabrice
authors.initials: F
authors.lastname: Jardin
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015992:Body Mass Index; D001830:Body Surface Area; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications* / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D018482:Muscle, Skeletal / Q000473:pathology; D009929:Organ Size; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D000069283:Rituximab; D055948:Sarcopenia / Q000150:complications* / Q000175:diagnosis; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone