Contributions
Abstract: PB2017
Type: Publication Only
Background
Loss of muscle mass has been reported to be an independent predictor of clinical outcome in multiple gastrointestinal cancers.
Aims
The decrease in the muscle mass may have an effect on the response to treatment in Hodgkin’s lymphoma(HL). We aimed to investigate the effect of chemotherapy on muscle mass in HL patients.
Methods
This study included 37 newly diagnosed HL patients who were referred to our clinic between 2010 and 2017. Patients were diagnosed after lymph node biopsy and initial evaluation was done by either PET-CT or computarized tomography (CT) and were staged according to Ann-Arbor Staging System and Cotswolds modification. Body surface areas were calculated. All patients received Adriamycin 25 mg/m2, Bleomycin 10 mg/m2, Vinblastine 6 mg/m2, Dacarbazine 375 mg/m2 (ABVD) chemotherapy administered intravenously on Day 1 and Day 15. Following 4 courses of the ABVD, an interim evaluation was carried out with CT. The computed tomographic scans of the patients before the treatment and after 4 courses of ABVD were available in the Picture Archive and Communication System (PACS) of the hospital. The L3 vertebra was identified on the axial CT and the posterior paravertebral muscle was manually contoured bilaterally to determine the skeletal muscle index. L3 skeletal muscle index and fat-free mass were calculated. The decrease in the muscle mass was defined by the presence of the posterior paravertebral area less than the median of the cohort.
Results
The median age of the patients was 41 (19-76) and Male/Female=26/11. There were 18 early-stage (stage I-II) and 19 advanced-stage (stage III-IV) patients. Partial and complete responses were observed in 24 and 10 patients, respectively. Three patients progressed despite treatment. When the treatment-based change of the paravertebral muscle area was examined, there was a statistically significant decrease in muscle area after 4 courses of treatment in both early and advanced stage disease (Table 1). There was no statistically significant difference between the early and advanced stage patients in terms of the pre-treatment paravertebral muscle area (p=0.46). When the subgroups were examined in terms of response to the treatment, there was no statistically significant difference in the basal muscle measurements of the patients with complete and partial responses and progression (p=0.44). However, a statistically significant decrease was determined in the paravertebral muscle area following the chemotherapy in patients with complete and partial response to the treatment; while there was a distinct but statistically insignificant decrease in the muscle mass in patients with progression (p values 0.028, 0.002 and 0.18, respectively). The ratio of decrease in the paravertebral muscle area are shown in Figure 1.
Conclusion
There was a significant decrease in the muscle mass after the chemotherapy for HL. However, more data is required to determine its association with response to treatment.
Session topic: 17. Hodgkin lymphoma – Clinical
Keyword(s): Hodgkin's Lymphoma
Abstract: PB2017
Type: Publication Only
Background
Loss of muscle mass has been reported to be an independent predictor of clinical outcome in multiple gastrointestinal cancers.
Aims
The decrease in the muscle mass may have an effect on the response to treatment in Hodgkin’s lymphoma(HL). We aimed to investigate the effect of chemotherapy on muscle mass in HL patients.
Methods
This study included 37 newly diagnosed HL patients who were referred to our clinic between 2010 and 2017. Patients were diagnosed after lymph node biopsy and initial evaluation was done by either PET-CT or computarized tomography (CT) and were staged according to Ann-Arbor Staging System and Cotswolds modification. Body surface areas were calculated. All patients received Adriamycin 25 mg/m2, Bleomycin 10 mg/m2, Vinblastine 6 mg/m2, Dacarbazine 375 mg/m2 (ABVD) chemotherapy administered intravenously on Day 1 and Day 15. Following 4 courses of the ABVD, an interim evaluation was carried out with CT. The computed tomographic scans of the patients before the treatment and after 4 courses of ABVD were available in the Picture Archive and Communication System (PACS) of the hospital. The L3 vertebra was identified on the axial CT and the posterior paravertebral muscle was manually contoured bilaterally to determine the skeletal muscle index. L3 skeletal muscle index and fat-free mass were calculated. The decrease in the muscle mass was defined by the presence of the posterior paravertebral area less than the median of the cohort.
Results
The median age of the patients was 41 (19-76) and Male/Female=26/11. There were 18 early-stage (stage I-II) and 19 advanced-stage (stage III-IV) patients. Partial and complete responses were observed in 24 and 10 patients, respectively. Three patients progressed despite treatment. When the treatment-based change of the paravertebral muscle area was examined, there was a statistically significant decrease in muscle area after 4 courses of treatment in both early and advanced stage disease (Table 1). There was no statistically significant difference between the early and advanced stage patients in terms of the pre-treatment paravertebral muscle area (p=0.46). When the subgroups were examined in terms of response to the treatment, there was no statistically significant difference in the basal muscle measurements of the patients with complete and partial responses and progression (p=0.44). However, a statistically significant decrease was determined in the paravertebral muscle area following the chemotherapy in patients with complete and partial response to the treatment; while there was a distinct but statistically insignificant decrease in the muscle mass in patients with progression (p values 0.028, 0.002 and 0.18, respectively). The ratio of decrease in the paravertebral muscle area are shown in Figure 1.
Conclusion
There was a significant decrease in the muscle mass after the chemotherapy for HL. However, more data is required to determine its association with response to treatment.
Session topic: 17. Hodgkin lymphoma – Clinical
Keyword(s): Hodgkin's Lymphoma