Wadhwa Aman, Dai Chen, Kessel Sandra, Richman Joshua S, Shen Wei, Kahn Justine M, Castellino Sharon M, Kelly Kara M, Friedman Debra L, Bhatia Smita
Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama.
Division of Pediatric Hematology/Oncology, University of Alabama at Birmingham, Birmingham, Alabama.
Cancer Epidemiol Biomarkers Prev. 2025 Apr 3;34(4):560-567. doi: 10.1158/1055-9965.EPI-24-1231.
The association between skeletal, muscle, and adipose tissue (body composition) and early response using PET in pediatric Hodgkin lymphoma remains unstudied.
Patients enrolled on Children's Oncology Group studies AHOD0031 (intermediate-risk Hodgkin lymphoma) and AHOD0831 (high-risk Hodgkin lymphoma) with digital abdominal CT scans at diagnosis and PET scans after 2 cycles (PET2) were included. Two consecutive slices at the third lumbar vertebra were identified, and skeletal muscle index (SMI; in cm2/m2) and total adipose tissue index (TATI; in cm2/m2) were calculated using sliceOmatic and height at diagnosis. SMI and TATI were divided into quintiles [Q1 (lowest) to Q5 (highest)]. Body mass index (BMI) was calculated using height and weight at diagnosis. The association between baseline body composition (SMI, TATI, and BMI) and positive PET2 was examined using logistic regression, adjusting for age at diagnosis, sex, race/ethnicity, stage, histology, bulk disease, and "B" symptoms.
Among 1,033 included patients, PET2 was positive in 314 (30.4%) patients. SMI was not associated with positive PET2. Extremes of TATI were associated with positive PET2, when compared with the middle TATI quintile [reference: Q3; ORQ1 = 1.63; 95% confidence interval (CI) = 1.03-2.60; P = 0.04; ORQ2 = 1.82; 95% CI = 1.17-2.82; P = 0.008; ORQ5 = 1.94; 95% CI = 1.23-3.05; P = 0.005]. The association between BMI in obesity range and positive PET2 trended toward significance (OR = 1.42; 95% CI = 0.98-2.04; P = 0.06; ref = normal weight).
Extremes of adipose tissue at diagnosis influence early response among pediatric Hodgkin lymphoma.
Validation of results from this study could inform studies investigating body composition-based chemotherapy dosing.
在儿童霍奇金淋巴瘤中，骨骼、肌肉和脂肪组织（身体组成）与使用正电子发射断层扫描（PET）的早期反应之间的关联尚未得到研究。
纳入参加儿童肿瘤学组研究AHOD0031（中度风险霍奇金淋巴瘤）和AHOD0831（高度风险霍奇金淋巴瘤）的患者，这些患者在诊断时进行了数字化腹部CT扫描，并在2个周期后进行了PET扫描（PET2）。确定第三腰椎的连续两个切片，使用SliceOmatic软件和诊断时的身高计算骨骼肌指数（SMI；单位为cm²/m²）和总脂肪组织指数（TATI；单位为cm²/m²）。SMI和TATI被分为五分位数[Q1（最低）至Q5（最高）]。使用诊断时的身高和体重计算体重指数（BMI）。使用逻辑回归分析基线身体组成（SMI、TATI和BMI）与PET2阳性之间的关联，并对诊断时的年龄、性别、种族/民族、分期、组织学、大块疾病和“B”症状进行校正。
在10名纳入研究的患者中，314名（30.4%）患者的PET2呈阳性。SMI与PET2阳性无关。与TATI五分位数中间值相比，TATI的极值与PET2阳性相关[对照：Q3；ORQ1 = 1.63；95%置信区间（CI）= 1.03 - 2.60；P = 0.04；ORQ2 = 1.82；95% CI = 1.17 - 2.82；P = 0.008；ORQ5 = 1.94；95% CI = 1.23 - 3.05；P = 0.005]。肥胖范围内的BMI与PET2阳性之间的关联有显著趋势（OR = 1.42；95% CI = 0.98 - 2.04；P = 0.06；对照 = 正常体重）。
诊断时的脂肪组织极值影响儿童霍奇金淋巴瘤患者的早期反应。
本研究结果的验证可为基于身体组成的化疗剂量研究提供参考。
