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Evaluation of the cachexia index using a bioelectrical impedance analysis in elderly patients with non-Hodgkin’s lymphoma: A single-center prospective study

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Abstract

Cancer cachexia is a disorder that affects patient outcomes. The present study prospectively evaluated the prognostic value of the cachexia index (CXI) in elderly patients with non-Hodgkin’s lymphoma (NHL). We prospectively analyzed 51 elderly patients who were diagnosed with NHL at our institution. CXI was calculated as follows: CXI = SMI × Alb/NLR (SMI: skeletal muscle index, Alb: serum albumin, NLR: neutrophil-to-lymphocyte ratio). SMI was measured by a bioelectrical impedance analysis (BIA) using the InBody 720. We determined the sex-specific cutoff values of the CXI by a receiver operating characteristic curve analysis and divided all patients into low- and high-CXI groups. The median age at the diagnosis was 78 years (60–93 years), and 28 (55%) were male. The histologic subtypes were B-cell lymphoma in 49 patients and T-cell lymphoma in 2. Twenty-eight (55%) patients were categorized into the high-CXI group, and 23 (45%) were categorized into the low-CXI group. The overall survival (OS) in the low-CXI group was significantly shorter than that in the high-CXI group (3-year OS, 70.4% vs. 95.7%, p = 0.007). Among 23 patients with DLBCL, patients with low-CXI had shorter OS than those with high-CXI (3-year OS, 55.6% vs. 92.9%, p = 0.008). On the other hand, sarcopenia had less impact on the clinical outcome of DLBCL patients. Low-CXI was associated with poor outcomes in elderly NHL and the CXI may be a clinical useful index for predicting prognosis. Further large prospective studies are needed to verify this conclusion.

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Data availability

The data sets generated and analyzed during the current study are available from the corresponding author upon reasonable request.

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No specific funding was obtained to support the conduct of this study.

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Authors and Affiliations

  1. Department of Hematology, Yokohama Municipal Citizen’s Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan

    So Okubo, Kohei Shinmura, Saori Kadota, Misa Nakayasu, Shuhei Kurosawa, Hitomi Nakayama, Aki Sakurai, Chisako Ito, Yoshinobu Aisa & Tomonori Nakazato

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  1. So Okubo
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  2. Kohei Shinmura
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  3. Saori Kadota
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  4. Misa Nakayasu
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  5. Shuhei Kurosawa
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  6. Hitomi Nakayama
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  7. Aki Sakurai
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  8. Chisako Ito
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  9. Yoshinobu Aisa
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  10. Tomonori Nakazato
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Correspondence to Tomonori Nakazato.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from the patients. The study was approved by the Ethics Committee of Yokohama Municipal Citizen’s Hospital.

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Okubo, S., Shinmura, K., Kadota, S. et al. Evaluation of the cachexia index using a bioelectrical impedance analysis in elderly patients with non-Hodgkin’s lymphoma: A single-center prospective study. Ann Hematol 103, 823–831 (2024). https://doi.org/10.1007/s00277-023-05548-0

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