In this exploratory analysis of older patients with aggressive non-Hodgkin lymphoma, body composition on baseline CT was associated with overall survival and toxicity, underscoring imaging's potential for risk stratification.
Key Findings
Results
Higher subcutaneous adipose tissue index (SATI) z score was associated with increased odds of grade 3+ nonhematologic toxicity in univariate analysis.
Odds ratio of 1.77 for grade 3+ nonhematologic toxicity with higher SATI z score (p < .01)
Study population consisted of 87 patients with available imaging out of 105 enrolled adults ≥65 years old with aggressive non-Hodgkin lymphoma
Body composition was derived from pretreatment CT scans at the third lumbar vertebral level using a validated, fully automated pipeline with manual quality control
In multivariable analysis controlling for International Prognostic Index, higher SATI z score retained association with toxicity (OR, 1.89; p < .01)
Results
Higher SATI z score was associated with increased odds of unplanned hospitalization in univariate analysis.
Odds ratio of 1.67 for unplanned hospitalization with higher SATI z score (p = .01)
Analysis was conducted as part of univariate regression models evaluating multiple outcomes
SATI z score was age-adjusted and sex-adjusted
Results
Higher SATI z score showed a numerically greater odds of quality of life decline, though this did not reach conventional significance.
Odds ratio of 1.58 for quality of life decline (QOLD) with higher SATI z score (p = .06)
Quality of life was measured using FACT-Lym
The association did not meet the conventional threshold for statistical significance (p < .05)
Results
Higher skeletal muscle index (SMI) z score was associated with better overall survival in both univariate and multivariable analyses.
Univariate hazard ratio of 0.47 for overall survival with higher SMI z score (p = .04)
In multivariable analysis controlling for International Prognostic Index, higher SMI z score had HR of 0.50 (p = .05)
SMI z score was age-adjusted and sex-adjusted
Results
Higher SMI z score was associated with numerically lower odds of quality of life decline, though this did not reach conventional significance.
Odds ratio of 0.52 for quality of life decline with higher SMI z score (p = .07)
Quality of life was assessed using FACT-Lym
The association did not meet the conventional threshold for statistical significance (p < .05)
Results
No association was observed between visceral adipose tissue index (VATI) z score and any clinical outcome.
VATI z score was evaluated in the same univariate and multivariable regression models as SMI and SATI
Outcomes evaluated included overall survival, grade 3+ nonhematologic toxicity, unplanned hospitalization, and quality of life decline
VATI z score was age-adjusted and sex-adjusted
Methods
The study enrolled 105 older adults with aggressive non-Hodgkin lymphoma, of whom 87 had imaging available for body composition analysis.
Eligibility required age ≥65 years with aggressive non-Hodgkin lymphoma receiving chemoimmunotherapy
This was a longitudinal study design
Body composition analysis used a validated, fully automated pipeline at the third lumbar vertebral level with manual quality control
Indices derived included skeletal muscle index (SMI), subcutaneous adipose tissue index (SATI), and visceral adipose tissue index (VATI)
Mantz L, Johnson P, Lei M, Newcomb R, Stacey J, Yang D, et al.. (2026). Exploratory association of muscle and adipose tissue indices with clinical outcomes in aggressive lymphomas.. Cancer. https://doi.org/10.1002/cncr.70313