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

IF 3 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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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.