Prognostic Role of Sarcopenia in High-grade Lymphoma: A Retrospective PET/CT-Based Study

Aim: This study aimed to evaluate the impact of sarcopenia and myosteatosis on progression-free survival (PFS) in patients with aggressive non-Hodgkin lymphoma (NHL). Methods: A retrospective analysis was conducted on 33 high-grade NHL patients diagnosed between 01.01.2018 and 31.12.2019, who had p...

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Main Authors: Özlem Beyler, Yunus Güzel, Cengiz Demir, Serdar Yıldırım, Canan Can, Halil Kömek
Format: Article
Language:English
Published: Galenos Publishing House 2025-08-01
Series:Acta Haematologica Oncologica Turcica
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Online Access:https://www.actaoncologicaturcica.com/articles/prognostic-role-of-sarcopenia-in-high-grade-lymphoma-a-retrospective-petct-based-study/doi/ahot.galenos.2025.2025-4-10
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author Özlem Beyler
Yunus Güzel
Cengiz Demir
Serdar Yıldırım
Canan Can
Halil Kömek
author_facet Özlem Beyler
Yunus Güzel
Cengiz Demir
Serdar Yıldırım
Canan Can
Halil Kömek
author_sort Özlem Beyler
collection DOAJ
description Aim: This study aimed to evaluate the impact of sarcopenia and myosteatosis on progression-free survival (PFS) in patients with aggressive non-Hodgkin lymphoma (NHL). Methods: A retrospective analysis was conducted on 33 high-grade NHL patients diagnosed between 01.01.2018 and 31.12.2019, who had pre- and post-treatment 18F-fluorodeoxyglucose positron emission tomography/computed tomography (CT) imaging. Body composition was semiautomatically measured using axial CT slices at the lumbar L3 vertebral level, focusing on the psoas muscle (PM). The right and left average hounsfield unit (HU) values [right psoas HU corrected (RPHUc) and left psoas HU corrected (LPHUc)] were recorded as myosteatosis parameters. The cross-sectional area of the PM was adjusted for body size by dividing it by the square of the patient’s height in meters, resulting in the PM index, expressed in cm²/m². Results: The average age of the patients was 57±16.2 years, and sarcopenia was identified in 39.4% of the cohort. During follow-up, relapse occurred in 9 patients (27.3%). A significant association was found between relapse and age (p=0.002), Eastern Cooperative Oncology Group (ECOG) performance status (p=0.003), and RPHUc (p=0.015). Receiver operating characteristic analysis for RPHUc (cut-off >33.550) in predicting PFS showed an area under the curve of 0.778 (p=0.015), with 66.7% sensitivity and 33% specificity. Univariate analysis identified age (p=0.001), ECOG score (p=0.000), and RPHUc (p=0.017) as significant prognostic factors for PFS. In multivariate analysis, only age remained an independent prognostic factor (p=0.04). Conclusion: Our study demonstrated that age and RPHUc values have prognostic significance for PFS in aggressive lymphoma patients. These parameters, easily obtainable from routine imaging, may aid in guiding clinical management strategies.
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series Acta Haematologica Oncologica Turcica
spelling doaj-art-49c27c23fb8f4ee485761f63e088d98c2025-08-20T03:43:50ZengGalenos Publishing HouseActa Haematologica Oncologica Turcica3061-99472025-08-0158211011410.4274/ahot.galenos.2025.2025-4-10Prognostic Role of Sarcopenia in High-grade Lymphoma: A Retrospective PET/CT-Based StudyÖzlem Beyler0https://orcid.org/0000-0002-2032-8877Yunus Güzel1https://orcid.org/0000-0002-8555-0460Cengiz Demir2https://orcid.org/0000-0001-9856-184XSerdar Yıldırım3https://orcid.org/0000-0001-9422-1346Canan Can4https://orcid.org/0000-0002-0255-5830Halil Kömek5https://orcid.org/0000-0001-8168-136XUniversity of Health Sciences Türkiye, Gazi Yaşargil Training and Research Hospital, Clinic of Hematology, Diyarbakır, TürkiyeUniversity of Health Sciences Türkiye, Gazi Yaşargil Training and Research Hospital, Clinic of Nuclear Medicine, Diyarbakır, TürkiyeUniversity of Health Sciences Türkiye, Gazi Yaşargil Training and Research Hospital, Clinic of Hematology, Diyarbakır, TürkiyeUniversity of Health Sciences Türkiye, Gazi Yaşargil Training and Research Hospital, Clinic of Internal Medicine, Diyarbakır, TürkiyeUniversity of Health Sciences Türkiye, Gazi Yaşargil Training and Research Hospital, Clinic of Nuclear Medicine, Diyarbakır, TürkiyeUniversity of Health Sciences Türkiye, Gazi Yaşargil Training and Research Hospital, Clinic of Nuclear Medicine, Diyarbakır, TürkiyeAim: This study aimed to evaluate the impact of sarcopenia and myosteatosis on progression-free survival (PFS) in patients with aggressive non-Hodgkin lymphoma (NHL). Methods: A retrospective analysis was conducted on 33 high-grade NHL patients diagnosed between 01.01.2018 and 31.12.2019, who had pre- and post-treatment 18F-fluorodeoxyglucose positron emission tomography/computed tomography (CT) imaging. Body composition was semiautomatically measured using axial CT slices at the lumbar L3 vertebral level, focusing on the psoas muscle (PM). The right and left average hounsfield unit (HU) values [right psoas HU corrected (RPHUc) and left psoas HU corrected (LPHUc)] were recorded as myosteatosis parameters. The cross-sectional area of the PM was adjusted for body size by dividing it by the square of the patient’s height in meters, resulting in the PM index, expressed in cm²/m². Results: The average age of the patients was 57±16.2 years, and sarcopenia was identified in 39.4% of the cohort. During follow-up, relapse occurred in 9 patients (27.3%). A significant association was found between relapse and age (p=0.002), Eastern Cooperative Oncology Group (ECOG) performance status (p=0.003), and RPHUc (p=0.015). Receiver operating characteristic analysis for RPHUc (cut-off >33.550) in predicting PFS showed an area under the curve of 0.778 (p=0.015), with 66.7% sensitivity and 33% specificity. Univariate analysis identified age (p=0.001), ECOG score (p=0.000), and RPHUc (p=0.017) as significant prognostic factors for PFS. In multivariate analysis, only age remained an independent prognostic factor (p=0.04). Conclusion: Our study demonstrated that age and RPHUc values have prognostic significance for PFS in aggressive lymphoma patients. These parameters, easily obtainable from routine imaging, may aid in guiding clinical management strategies.https://www.actaoncologicaturcica.com/articles/prognostic-role-of-sarcopenia-in-high-grade-lymphoma-a-retrospective-petct-based-study/doi/ahot.galenos.2025.2025-4-10lymphomasarcopeniaprogression free survivalpsoas musclemyosteatosis
spellingShingle Özlem Beyler
Yunus Güzel
Cengiz Demir
Serdar Yıldırım
Canan Can
Halil Kömek
Prognostic Role of Sarcopenia in High-grade Lymphoma: A Retrospective PET/CT-Based Study
Acta Haematologica Oncologica Turcica
lymphoma
sarcopenia
progression free survival
psoas muscle
myosteatosis
title Prognostic Role of Sarcopenia in High-grade Lymphoma: A Retrospective PET/CT-Based Study
title_full Prognostic Role of Sarcopenia in High-grade Lymphoma: A Retrospective PET/CT-Based Study
title_fullStr Prognostic Role of Sarcopenia in High-grade Lymphoma: A Retrospective PET/CT-Based Study
title_full_unstemmed Prognostic Role of Sarcopenia in High-grade Lymphoma: A Retrospective PET/CT-Based Study
title_short Prognostic Role of Sarcopenia in High-grade Lymphoma: A Retrospective PET/CT-Based Study
title_sort prognostic role of sarcopenia in high grade lymphoma a retrospective pet ct based study
topic lymphoma
sarcopenia
progression free survival
psoas muscle
myosteatosis
url https://www.actaoncologicaturcica.com/articles/prognostic-role-of-sarcopenia-in-high-grade-lymphoma-a-retrospective-petct-based-study/doi/ahot.galenos.2025.2025-4-10
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AT cengizdemir prognosticroleofsarcopeniainhighgradelymphomaaretrospectivepetctbasedstudy
AT serdaryıldırım prognosticroleofsarcopeniainhighgradelymphomaaretrospectivepetctbasedstudy
AT canancan prognosticroleofsarcopeniainhighgradelymphomaaretrospectivepetctbasedstudy
AT halilkomek prognosticroleofsarcopeniainhighgradelymphomaaretrospectivepetctbasedstudy