Impact of Body Composition on Treatment Toxicity and Outcomes in Patients With Primary Mediastinal Large B‐Cell Lymphoma

作者：Juliette Pénichoux, Pierre Decazes, Cédric Rossi, Pierre Sesques, Corinne Haïoun, Éric Durot, Nicolas Gower, Alexandre Willaume, Lucie Obéric, Jérôme Paillassa, Chloé Antier, Loïc Renaud, Olivier Tournilhac, Catherine Thieblemont, Caroline Besson, Laure Lebras, Sylvain Choquet, Katell Le Dû, Christophe Bonnet, Sarah Bailly, G. Damaj, Kamel Laribi, Roch Houot, Adrien Chauchet, Stéphanie Becker, David Tonnelet, Hervé Tilly, Fabrice Jardin, Émilie Lévêque, Vincent Camus · 发表于：Hematological Oncology · 年份：2025 · DOI：10.1002/hon.70117 · 被引用次数：2 · 研究领域：Nutrition and Health in Aging、Lymphoma Diagnosis and Treatment、Childhood Cancer Survivors' Quality of Life

ABSTRACT Primary mediastinal large B‐cell lymphoma (PMBL) is a rare entity that predominantly affects young female patients and typically presents as a large and compressive anterior mediastinal mass. Accumulating evidence suggests relationships among PMBL patient body composition (BC), cancer outcomes, and treatment‐related toxicities. The aim of this study was to evaluate the impact of BC on PMBL patients using PET‐CT images acquired pretreatment. Two hundred nineteen patients were included in an ancillary analysis of a multicenter retrospective LYSA cohort of treatment‐naïve adult PMBL patients who received first‐line treatment with ACVBP, CHOP14 or CHOP21 plus anti‐CD20. Anthropometric parameters were assessed from the baseline PET‐CT image using two methods: (i) manual segmentation at the L3 level and (ii) automatic software‐based multislice measurements with Anthropometer3DNet. The median age was 35.4 years (range 18–88 years), and the median body mass index was 23.8 kg/m 2 (15.6; 40.8). Overall, 137 patients were treated with R‐ACVBP, 44 received R‐CHOP14, and 38 were treated with R‐CHOP21. Patients with low lean body mass had a higher incidence of febrile neutropenia, both in the overall cohort (25% vs. 12.6%, p = 0.02) and in the R‐ACVBP subgroup (35.7% vs. 19.4%, p = 0.03). Univariate analysis showed that in patients treated with R‐ACVBP, subcutaneous low adiposity, determined by 3D measurements, was associated with overall survival (OS) ( p = 0.04). At 3 years, the...