Metabolic Biomarkers Assessed with PET/CT Predict Sex-Specific Longitudinal Outcomes in Patients with Diffuse Large B-Cell Lymphoma

In many cancers, including lymphoma, males have higher incidence and mortality than females. Emerging evidence demonstrates that one mechanism underlying this phenomenon is sex differences in metabolism, both with respect to tumor nutrient consumption and systemic alterations in metabolism, i.e., ob...

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Published in:Cancers 2022-06, Vol.14 (12), p.2932
Main Authors: Jaswal, Shama, Sanders, Vanessa, Pullarkat, Priyanka, Teja, Stephanie, Salter, Amber, Watkins, Marcus P, Atagu, Norman, Ludwig, Daniel R, Mhlanga, Joyce, Mellnick, Vincent M, Peterson, Linda R, Bartlett, Nancy L, Kahl, Brad S, Fehniger, Todd A, Ghobadi, Armin, Cashen, Amanda F, Mehta-Shah, Neha, Ippolito, Joseph E
Format: Article
Language:English
Subjects:
B-cell lymphoma
Biomarkers
Body mass
Body mass index
Chemotherapy
Computed tomography
Females
Gender differences
Genotype & phenotype
Glucose
Lean body mass
Lymphocytes B
Lymphoma
Males
Medical prognosis
Metabolism
Mortality
Obesity
Patients
Positron emission tomography
Sex differences
Software
Tumors
Work stations
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Summary:In many cancers, including lymphoma, males have higher incidence and mortality than females. Emerging evidence demonstrates that one mechanism underlying this phenomenon is sex differences in metabolism, both with respect to tumor nutrient consumption and systemic alterations in metabolism, i.e., obesity. We wanted to determine if visceral fat and tumor glucose uptake with fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) could predict sex-dependent outcomes in patients with diffuse large B-cell lymphoma (DLBCL). We conducted a retrospective analysis of 160 patients (84 males; 76 females) with DLBCL who had imaging at initial staging and after completion of therapy. CT-based relative visceral fat area (rVFA), PET-based SUVmax normalized to lean body mass (SULmax), and end-of-treatment FDG-PET 5PS score were calculated. Increased rVFA at initial staging was an independent predictor of poor OS only in females. At the end of therapy, increase in visceral fat was a significant predictor of poor survival only in females. Combining the change in rVFA and 5PS scores identified a subgroup of females with visceral fat gain and high 5PS with exceptionally poor outcomes. These data suggest that visceral fat and tumor FDG uptake can predict outcomes in DLBCL patients in a sex-specific fashion.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers14122932