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The association of body composition and outcomes following autologous hematopoietic stem cell transplantation in patients with non-Hodgkin lymphoma

Bone Marrow Transplantation volume 58, pages 1384–1389 (2023)Cite this article

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Abstract

Recently there has been a growing interest in evaluating body composition as a marker for prognosis in cancer patients. The association of body composition parameters and outcomes has not been deeply investigated in patients with autologous hematopoietic stem cell transplantation (HSCT) recipients with non-Hodgkin lymphoma (NHL). We conducted a retrospective cohort study of 264 NHL patients who received autologous HSCT. PreHSCT abdominal CT scans at the levels of L3 were assessed for body composition measures. We evaluated sarcopenia, myosteatosis, high visceral adipose tissue (VAT) and high visceral adipose tissue density (VATD). Using multivariable Cox proportional regression, we analyzed the association of clinical and transplant-related characteristics with overall survival (OS), relapse-free survival (RFS), and non-relapse mortality (NRM). In a multivariate regression model, patients with higher VATD had worse OS (HR 1.78; 95% confidence intervals CI 1.08–2.95, p = 0.02) and worse NRM (HR 2.31 95% CI 1.08–4.95, p = 0.02) than with lower VATD. Patients with lower levels of VAT also had worse RFS (HR 1.49 95% CI 1.03–2.15, p = 0.03). Sarcopenia and myosteatosis were not associated with outcomes. High pre-transplant VATD was associated with lower OS and higher NRM, and low pre-transplant VAT was associated with worse RFS in patients with NHL undergoing autologous HSCT.

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Fig. 1: Adiposity radiodensity explained.
Fig. 2: Correlation of VAT and VATD.
Fig. 3: Kaplan–Meier curves VATD overall survival.
Fig. 4: Kaplan–Meier curves VAT relapse-free survival.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available due to confidentiality reasons but are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Internal Medicine Residency Program, Cleveland Clinic, Cleveland, OH, USA

    Gabriel F. P. Aleixo

  2. Blood and Marrow Transplant Program, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA

    Wei Wei, Faiz Anwer, Robert Dean, Betty K. Hamilton, Brian T. Hill, Deepa Jagadeesh, Jack Khouri, Brad Pohlman, Ronald Sobecks, Allison Winter & Paolo Caimi

  3. Department of Radiology, Cleveland Clinic, Cleveland, OH, USA

    Po-Hao Chen & Namita S. Gandhi

  4. Sarah Cannon Cancer Institute, Nashville, TN, USA

    Navneet S. Majhail

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Contributions

GFPA and NSM—conceptualization, data curation, investigation, methodology, project administration, resources, software, supervision, validation, visualization, writing the original draft and writing review and editing. WW—formal analysis and writing review and editing. P-HC and NSG—conceptualization, investigation, methodology, supervision, validation, visualization, writing to review and editing. FA, RD, BKH, BTH, DJ, JK, BP, RS, AW and PC—data curation, methodology, investigation, validation, visualization, writing to review and editing.

Corresponding author

Correspondence to Navneet S. Majhail.

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None of the authors has any conflict of interest to declare in relation to this study. Outside the scope of this research, the following authors have financial conflicts of interest to report: NSM serves consultant for Anthem, Inc and own stock from HCA Healthcare.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Cleveland Clinic Consent to participate.

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Aleixo, G.F.P., Wei, W., Chen, PH. et al. The association of body composition and outcomes following autologous hematopoietic stem cell transplantation in patients with non-Hodgkin lymphoma. Bone Marrow Transplant 58, 1384–1389 (2023). https://doi.org/10.1038/s41409-023-02104-2

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