Body composition changes in pediatric patients with lymphoma after chemotherapy: a retrospective study.

IF 2.6 3区医学 Q1 PEDIATRICS European Journal of Pediatrics Pub Date : 2025-02-06 DOI:10.1007/s00431-025-06011-0

Nathalia Farache Tostes, Beatriz Pereira de Carvalho, Isabella Caroline Santana Aleixo, Nilian Carla Souza, Danúbia da Cunha Antunes Saraiva, Renata Brum Martucci

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引用次数: 0

Abstract

Chemotherapy can alter body composition, including loss of skeletal muscle mass and density changes, which are linked to negative outcomes. This study investigates body composition changes in children and adolescents with lymphoma, focusing on the impact of chemotherapy protocols and diagnoses. A retrospective observational study included 49 lymphoma patients (ages 6-18) who underwent chemotherapy from 2017 to 2021, excluding palliative care cases. Data on disease, treatment, weight, and height were collected, and anthropometric indices, Body Mass Index by Age (BMI/A) and height by age (H/A) were calculated. Body composition was analyzed using Computed tomography (CT) at the third lumbar vertebra region (L3) with Slice-O-Matic 5.0 software, measuring skeletal muscle area (SMA), skeletal muscle density (SMD) measured in Hounsfield units (HU), total psoas muscle area (PMA), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and intramuscular adipose tissue (IMAT). Paired t-tests compared variables before and after treatment, and the delta of body composition parameters was stratified by chemotherapy protocols and diagnoses (Kruskal-Wallis Test), considering p < 0.05 as significant. Forty-nine patients were included (mean age 13.24 years, 49% male). After chemotherapy, there was an increase in SAT, VAT, IMAT, and SMA (p < 0.001), while SMD decreased from 41 HU to 35.27 HU (p < 0.001). The EURONET protocol and Hodgkin lymphoma were associated with increases in SAT (∆ = 78.28 cm²/73.92 cm²) and VAT (∆ = 27.44 cm²/26.36 cm²).

Conclusions: Significant adipose tissue gains were observed in the EURONET protocol and Hodgkin lymphoma, highlighting the impact of chemotherapy on body composition.

What is known: • Computed tomography is used to assess body composition, including muscle, adipose tissue and muscle density in adults. • Chemotherapy treatment negatively affects body composition, reducing muscle mass in adults with cancer.

What is new: • Computed tomography can also be used to assess body composition in children and adolescents with cancer. • In pediatrics, chemotherapy can also impact body composition, with changes varying according to the administered protocol.

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儿童淋巴瘤患者化疗后体成分的变化：一项回顾性研究。

化疗可以改变身体成分，包括骨骼肌质量的损失和密度的变化，这些都与负面结果有关。本研究探讨儿童和青少年淋巴瘤患者的身体成分变化，重点关注化疗方案和诊断的影响。一项回顾性观察性研究纳入了2017年至2021年期间接受化疗的49例淋巴瘤患者（6-18岁），不包括姑息治疗病例。收集疾病、治疗、体重和身高数据，计算人体测量指数、年龄体质指数（BMI/A）和年龄身高（H/A）。采用cut - o - matic 5.0软件对第三腰椎区（L3）的计算机断层扫描（CT）进行体成分分析，测量骨骼肌面积（SMA）、骨骼肌密度（SMD）（Hounsfield单位（HU））、腰肌总面积（PMA）、皮下脂肪组织（SAT）、内脏脂肪组织（VAT）和肌内脂肪组织（IMAT）。配对t检验比较治疗前后的变量，考虑p 2/73.92 cm2和VAT(∆= 27.44 cm2/26.36 cm2)，根据化疗方案和诊断对体成分参数的δ进行分层（Kruskal-Wallis检验）。结论：在EURONET方案和霍奇金淋巴瘤中观察到显著的脂肪组织增加，突出了化疗对身体成分的影响。•计算机断层扫描用于评估成人的身体组成，包括肌肉、脂肪组织和肌肉密度。•化疗会对身体成分产生负面影响，减少成年癌症患者的肌肉质量。最新进展：•计算机断层扫描也可用于评估患有癌症的儿童和青少年的身体成分。•在儿科，化疗也会影响身体成分，根据给药方案的不同而有不同的变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pediatrics 医学-小儿科

CiteScore

5.90

自引率

2.80%

发文量

367

审稿时长

3-6 weeks

期刊介绍： The European Journal of Pediatrics (EJPE) is a leading peer-reviewed medical journal which covers the entire field of pediatrics. The editors encourage authors to submit original articles, reviews, short communications, and correspondence on all relevant themes and topics. EJPE is particularly committed to the publication of articles on important new clinical research that will have an immediate impact on clinical pediatric practice. The editorial office very much welcomes ideas for publications, whether individual articles or article series, that fit this goal and is always willing to address inquiries from authors regarding potential submissions. Invited review articles on clinical pediatrics that provide comprehensive coverage of a subject of importance are also regularly commissioned. The short publication time reflects both the commitment of the editors and publishers and their passion for new developments in the field of pediatrics. EJPE is active on social media (@EurJPediatrics) and we invite you to participate. EJPE is the official journal of the European Academy of Paediatrics (EAP) and publishes guidelines and statements in cooperation with the EAP.