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Impact of cachexia on outcomes in aggressive lymphomas

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Abstract

Cancer cachexia is defined as a state of involuntary weight loss, attributed to altered body composition with muscle mass loss and/or loss of adiposity. Identifying the association between cancer cachexia and outcomes may pave the way for novel agents that target the cancer cachexia process. Clinical parameters for measurement of cancer cachexia are needed. We conducted a single-institution retrospective analysis that included 86 NHL patients with the aim of identifying an association between cancer cachexia and outcomes in aggressive lymphomas using the cachexia index (CXI) suggested by Jafri et al. (Clin Med Insights Oncol 9:87–93, 15). Impact of cachexia factors on progression-free survival (PFS) and overall survival (OS) were assessed using log-rank test and Cox proportional hazards regression. Patients were dichotomized around the median CXI into “non-cachectic” (CXI ≥49.8, n = 41) and “cachectic” (CXI <49.8, n = 40) groups. Cachectic patients had significantly worse PFS (HR 2.18, p = 0.044) and OS (HR = 4.05, p = 0.004) than non-cachectic patients. Cachexia as defined by the CXI is prognostic in aggressive lymphomas and implies that novel therapeutic strategies directed at reversing cachexia may improve survival in this population.

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Authors and Affiliations

  1. Division of Hematology, Oncology and Cell Therapy, Rush University Medical Center, Chicago, IL, USA

    Reem Karmali, Vineela Chukkapalli, Sunita Nathan, Kelly Szymanski-Grant & Parameswaran Venugopal

  2. Rush University Medical Center, Chicago, IL, USA

    Taha Alrifai, Ibtihaj A. M. Fughhi & Sanjib Basu

  3. University of Illinois, Chicago, IL, USA

    Ronald Ng

  4. Department of Radiology, Rush University Medical Center, Chicago, IL, USA

    Palmi Shah

  5. Division of Hematology, Oncology, Northwestern University, Chicago, IL, USA

    Leo I. Gordon

  6. Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA

    Leo I. Gordon & Frank J. Penedo

  7. Departments of Medical Social Sciences, Psychology & Psychiatry and Behavioral Sciences, Northwestern University, Axis Apartments & Lofts, 446 E Ontario St, Chicago, IL, 60611, USA

    Frank J. Penedo

  8. Departments of Pathology and Biochemistry, Rush University Medical Center, Chicago, IL, USA

    Jeffrey A. Borgia

Authors
  1. Reem Karmali
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  2. Taha Alrifai
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  3. Ibtihaj A. M. Fughhi
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  4. Ronald Ng
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  6. Palmi Shah
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  9. Kelly Szymanski-Grant
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  13. Jeffrey A. Borgia
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Correspondence to Reem Karmali.

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Karmali, R., Alrifai, T., Fughhi, I.A.M. et al. Impact of cachexia on outcomes in aggressive lymphomas. Ann Hematol 96, 951–956 (2017). https://doi.org/10.1007/s00277-017-2958-1

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  • DOI: https://doi.org/10.1007/s00277-017-2958-1

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