Prognostic impact of pretreatment skeletal muscle index and CONUT score in diffuse large B-cell Lymphoma
Abstract Background Although the prognostic value of the Controlling Nutritional Status (CONUT) score in diffuse large B-cell lymphoma (DLBCL) has been reported in several previous studies, its clinical relevance for the presence of sarcopenia has not been assessed. Methods In this study, 305 DLBCL...
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| Format: | Article |
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BMC
2023-11-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-023-11590-y |
| _version_ | 1797630153560424448 |
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| author | Se-Il Go Bong-Hoi Choi Mi Jung Park Sungwoo Park Myoung Hee Kang Hoon-Gu Kim Jung Hun Kang Eun Jeong Jeong Gyeong-Won Lee |
| author_facet | Se-Il Go Bong-Hoi Choi Mi Jung Park Sungwoo Park Myoung Hee Kang Hoon-Gu Kim Jung Hun Kang Eun Jeong Jeong Gyeong-Won Lee |
| author_sort | Se-Il Go |
| collection | DOAJ |
| description | Abstract Background Although the prognostic value of the Controlling Nutritional Status (CONUT) score in diffuse large B-cell lymphoma (DLBCL) has been reported in several previous studies, its clinical relevance for the presence of sarcopenia has not been assessed. Methods In this study, 305 DLBCL patients were reviewed. They were categorized into normal/mild (n = 219) and moderate/severe (n = 86) CONUT groups. Sarcopenia was assessed using the L3-skeletal muscle index measured by baseline computed tomography imaging. Based on CONUT score and sarcopenia, patients were grouped: A (normal/mild CONUT and no sarcopenia), B (either moderate/severe CONUT or sarcopenia, but not both), and C (both moderate/severe CONUT and sarcopenia). Results The moderate/severe CONUT group showed higher rates of ≥ grade 3 febrile neutropenia, thrombocytopenia, non-hematologic toxicities, and early treatment discontinuation not related to disease progression, compared to the normal/mild CONUT group. The moderate/severe CONUT group had a lower complete response rate (58.1% vs. 80.8%) and shorter median overall survival (18.5 vs. 162.6 months) than the normal/mild group. Group C had the poorest prognosis with a median survival of 8.6 months, while groups A and B showed better outcomes (not reached and 60.1 months, respectively). Combining CONUT score and sarcopenia improved the predictive accuracy of the Cox regression model (C-index: 0.763), compared to the performance of using either CONUT score (C-index: 0.754) or sarcopenia alone (C-index: 0.755). Conclusions In conclusion, the moderate/severe CONUT group exhibited treatment intolerance, lower response, and poor prognosis. Additionally, combining CONUT score and sarcopenia enhanced predictive accuracy for survival outcomes compared to individual variables. |
| first_indexed | 2024-03-11T11:03:00Z |
| format | Article |
| id | doaj.art-2aaa9ff1de2a45779e6bc38740562669 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-03-11T11:03:00Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-2aaa9ff1de2a45779e6bc387405626692023-11-12T12:20:30ZengBMCBMC Cancer1471-24072023-11-0123111010.1186/s12885-023-11590-yPrognostic impact of pretreatment skeletal muscle index and CONUT score in diffuse large B-cell LymphomaSe-Il Go0Bong-Hoi Choi1Mi Jung Park2Sungwoo Park3Myoung Hee Kang4Hoon-Gu Kim5Jung Hun Kang6Eun Jeong Jeong7Gyeong-Won Lee8Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of MedicineDepartment of Nuclear Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of MedicineDepartment of Radiology, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of MedicineDivision of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of MedicineDivision of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of MedicineDivision of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of MedicineDivision of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of MedicineDivision of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of MedicineDivision of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of MedicineAbstract Background Although the prognostic value of the Controlling Nutritional Status (CONUT) score in diffuse large B-cell lymphoma (DLBCL) has been reported in several previous studies, its clinical relevance for the presence of sarcopenia has not been assessed. Methods In this study, 305 DLBCL patients were reviewed. They were categorized into normal/mild (n = 219) and moderate/severe (n = 86) CONUT groups. Sarcopenia was assessed using the L3-skeletal muscle index measured by baseline computed tomography imaging. Based on CONUT score and sarcopenia, patients were grouped: A (normal/mild CONUT and no sarcopenia), B (either moderate/severe CONUT or sarcopenia, but not both), and C (both moderate/severe CONUT and sarcopenia). Results The moderate/severe CONUT group showed higher rates of ≥ grade 3 febrile neutropenia, thrombocytopenia, non-hematologic toxicities, and early treatment discontinuation not related to disease progression, compared to the normal/mild CONUT group. The moderate/severe CONUT group had a lower complete response rate (58.1% vs. 80.8%) and shorter median overall survival (18.5 vs. 162.6 months) than the normal/mild group. Group C had the poorest prognosis with a median survival of 8.6 months, while groups A and B showed better outcomes (not reached and 60.1 months, respectively). Combining CONUT score and sarcopenia improved the predictive accuracy of the Cox regression model (C-index: 0.763), compared to the performance of using either CONUT score (C-index: 0.754) or sarcopenia alone (C-index: 0.755). Conclusions In conclusion, the moderate/severe CONUT group exhibited treatment intolerance, lower response, and poor prognosis. Additionally, combining CONUT score and sarcopenia enhanced predictive accuracy for survival outcomes compared to individual variables.https://doi.org/10.1186/s12885-023-11590-yLymphomaDiffuse large B-cellCachexiaMalnutritionSarcopeniaControlling nutritional status |
| spellingShingle | Se-Il Go Bong-Hoi Choi Mi Jung Park Sungwoo Park Myoung Hee Kang Hoon-Gu Kim Jung Hun Kang Eun Jeong Jeong Gyeong-Won Lee Prognostic impact of pretreatment skeletal muscle index and CONUT score in diffuse large B-cell Lymphoma BMC Cancer Lymphoma Diffuse large B-cell Cachexia Malnutrition Sarcopenia Controlling nutritional status |
| title | Prognostic impact of pretreatment skeletal muscle index and CONUT score in diffuse large B-cell Lymphoma |
| title_full | Prognostic impact of pretreatment skeletal muscle index and CONUT score in diffuse large B-cell Lymphoma |
| title_fullStr | Prognostic impact of pretreatment skeletal muscle index and CONUT score in diffuse large B-cell Lymphoma |
| title_full_unstemmed | Prognostic impact of pretreatment skeletal muscle index and CONUT score in diffuse large B-cell Lymphoma |
| title_short | Prognostic impact of pretreatment skeletal muscle index and CONUT score in diffuse large B-cell Lymphoma |
| title_sort | prognostic impact of pretreatment skeletal muscle index and conut score in diffuse large b cell lymphoma |
| topic | Lymphoma Diffuse large B-cell Cachexia Malnutrition Sarcopenia Controlling nutritional status |
| url | https://doi.org/10.1186/s12885-023-11590-y |
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