The prognostic impact of body composition assessed by computed tomography in adult patients with newly diagnosed acute lymphoblastic leukemia

被引:0
作者
Rios-Olais, Fausto Alfredo [1 ,5 ]
Gil-Lopez, Fernando [2 ]
Mora-Canas, Analy [1 ]
Zalapa-Soto, Jessica [1 ]
Rosales-Sotomayor, Guillermo [3 ]
Gabutti-Thomas, Alejandro [4 ]
Demichelis-Gomez, Roberta [1 ,5 ]
机构
[1] Inst Nacl Ciencias Med Nutr Salvador Zubiran, Hematol & Oncol Dept, Vasco Quiroga 15, Mexico City 14080, Mexico
[2] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Internal Med Dept, Mexico City, Mexico
[3] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Gastroenterol Dept, Mexico City, Mexico
[4] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Radiol Dept, Mexico City, Mexico
[5] Univ Nacl Autonoma Mexico, Mexico City, Mexico
关键词
Acute leukemia; Body composition; Obesity; Sarcopenia; Survival; SARCOPENIC OBESITY; MASS INDEX; LYMPHOMA; SURVIVAL; CHILDHOOD; CACHEXIA; CHILDREN; ASPARAGINASE; LIMITATIONS; MECHANISMS;
D O I
10.1016/j.clnesp.2025.02.010
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background: Body composition has emerged as a significant determinant of cancer patient outcomes, with computed tomography (CT) assessment at the L3 level offering a reliable evaluation method. While muscle mass and adiposity have been linked to poorer outcomes in hematological malignancies, their impact remains unstudied in adults with acute lymphoblastic leukemia (ALL). Methods: This retrospective single-center study enrolled adults newly diagnosed with ALL. Skeletal muscle, visceral, and subcutaneous fat areas were quantified. Low muscle mass was defined as a skeletal muscle index (SMI) less than 55 cm2/m2 in men, and less than 39 cm2/m2 in women, and receiver operating characteristic curves determined cutoff points for SMI, subcutaneous adipose tissue index (SATI) and visceral adipose tissue index (VATI) correlated with mortality. Results: Ninety patients were included. Low muscle mass was associated with mortality in patients treated with a pediatric inspired regimen (PIR) (HR 4.92, 95 % CI [1.38-17.57], p = 0.014) and lower median SMI was observed in patients who died during induction (p = 0.016). High visceral adiposity (HR 1.89, 95 % CI [1-3.57], p = 0.049) and high subcutaneous adiposity (HR 1.99, 95 % CI [1-3.96], p = 0.05) were also associated with mortality in the whole population. Furthermore, a higher VATI was observed in patients who developed an infectious episode during induction (p = 0.03), and a higher VATI was observed in patients who were treated with a PIR who had measurable residual disease positivity after induction chemotherapy (p = 0.044). Conclusion: CT-assessed muscle mass, and adiposity bear prognostic significance in newly diagnosed ALL patients. (c) 2025 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
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页码:539 / 546
页数:8
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