Cachexia index as a potential biomarker for cancer cachexia and a prognostic indicator in diffuse large B‐cell lymphoma

• Published in: Journal of cachexia, sarcopenia and muscle sarcopenia and muscle, 2021-12, Vol.12 (6), p.2211-2219
• Main Authors: Go, Se‐Il, Park, Mi Jung, Park, Sungwoo, Kang, Myoung Hee, Kim, Hoon‐Gu, Kang, Jung Hun, Kim, Jung Hoon, Lee, Gyeong‐Won
• Format: Article
• Language: English
• Subjects: Abdomen; Antibodies, Monoclonal, Murine-Derived - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Biomarkers; Body mass index; Cachexia; Cachexia - diagnosis; Cachexia - etiology; diffuse; Female; Humans; Laboratories; large B‐cell; Lung cancer; Lymphoma; Lymphoma, Large B-Cell, Diffuse - complications; Lymphoma, Large B-Cell, Diffuse - diagnosis; Lymphoma, Large B-Cell, Diffuse - drug therapy; Male; Medical imaging; Medical prognosis; Neutrophils; Original; Patients; Prognosis; Regression analysis; Retrospective Studies; Sarcopenia; Serum albumin
• ISSN: 2190-5991; 2190-6009
• DOI: 10.1002/jcsm.12837

Background Cancer cachexia is known to adversely affect the clinical course in patients with malignant lymphoma. The cachexia index (CXI) is a potential biomarker of cancer cachexia, and its implications for the prognosis and treatment outcome of lung cancer and aggressive lymphoma has been assessed in previous studies. Methods A total of 267 patients diagnosed with diffuse large B‐cell lymphoma who were treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R‐CHOP) immunochemotherapy were retrospectively reviewed. The CXI was calculated as the skeletal muscle index (SMI) × serum albumin/neutrophil–lymphocyte ratio (NLR). Although previous studies measured the SMI using the muscles of the L3 vertebral level, the present study used both the L3 vertebral muscles and the pectoralis muscles (PM) at the T4 vertebral level to measure the SMI. Depending on the type of muscles used, the CXI was termed the L3‐CXI or PM‐CXI. Using sex‐specific cutoff values for CXI, the patients were categorized as follows: (i) high‐CXI group (high L3‐CXI and high PM‐CXI), (ii) intermediate‐CXI group (high L3‐CXI and low PM‐CXI), and (iii) low‐CXI group (low L3‐CXI and low PM‐CXI). Results Complete responses to R‐CHOP were obtained in 145/173 (83.8%), 25/36 (69.4%), and 27/57 (47.4%) patients in the high‐CXI, intermediate‐CXI, and low‐CXI groups, respectively (P