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弥漫性大 B 细胞淋巴瘤患者低肌肉量和低肌肉密度的预后影响。

Prognostic impact of low muscle mass and low muscle density in patients with diffuse large B-cell lymphoma.

机构信息

Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands.

Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.

出版信息

Leuk Lymphoma. 2020 Jul;61(7):1618-1626. doi: 10.1080/10428194.2020.1737686. Epub 2020 Mar 13.

Abstract

Low muscle mass (LMM) and low muscle density (LMD) are increasingly recognized as prognostic factors for survival in different malignancies. This study determined the association of LMM and LMD with survival in DLBCL (diffuse large B-cell lymphoma) patients. CT-based measurement of muscle was performed in 164 DLBCL patients prior to chemo-immunotherapy. -scores adjusted for gender, age, and body mass index were derived from a healthy reference population. LMM or LMD were defined as a -score below -1 and were related to OS and PFS. The co-existence of both LMM and LMD was observed in 13% of the DLBCL patients and was significantly associated with shorter OS and PFS. Also, these patients more often did not complete the planned treatment. The combination of LMM and LMD is an independent prognostic factor for survival in DLBCL patients. This may guide clinical decision-making in patients with suspected insufficient performance to benefit from chemo-immunotherapy in standard doses.Key pointsPatients with DLBCL have low muscle mass (LMM) and low muscle density (LMD) compared to healthy counterparts.The combination of LMM and LMD is a negative prognostic factor for survival, independent of comorbidities and unfavorable lymphoma characteristics.

摘要

肌肉减少症(LMM)和肌肉密度降低(LMD)已被越来越多地认为是不同恶性肿瘤患者生存的预后因素。本研究旨在确定 LMM 和 LMD 与 DLBCL(弥漫性大 B 细胞淋巴瘤)患者生存的相关性。在接受化疗免疫治疗前,对 164 例 DLBCL 患者进行了基于 CT 的肌肉测量。从健康参考人群中得出了经过性别、年龄和体重指数调整的 -评分。LMM 或 LMD 的定义为 -评分低于-1,并与 OS 和 PFS 相关。在 13%的 DLBCL 患者中观察到 LMM 和 LMD 同时存在,并且与较短的 OS 和 PFS 显著相关。此外,这些患者往往无法完成计划的治疗。LMM 和 LMD 的并存是 DLBCL 患者生存的独立预后因素。这可能会指导对怀疑不能从标准剂量化疗免疫治疗中获益的患者的临床决策。

关键点

  1. 与健康对照相比,DLBCL 患者的肌肉减少症(LMM)和肌肉密度降低(LMD)。

  2. LMM 和 LMD 的并存是独立于合并症和不良淋巴瘤特征的生存的负性预后因素。

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