Dataset Information

Longitudinal Body Composition Changes in Diffuse Large B-cell Lymphoma Survivors: A Retrospective Cohort Study of United States Veterans.

ABSTRACT: Body composition parameters are associated with long-term health outcomes. We assessed longitudinal body composition changes in diffuse large B-cell lymphoma (DLBCL) survivors and identified clinical variables associated with the long-term development of sarcopenia and visceral obesity.A retrospective cohort of United States veterans with DLBCL treated with cyclophosphamide, doxorubicin, vincristine, and prednisone, with or without rituximab, was assembled. Muscle, subcutaneous fat, and visceral fat areas were measured with computed tomography analysis. Data were analyzed with repeated-measures analysis of variance and logistic regression. All statistical tests were two-sided.Three hundred forty-two patients were included. Muscle area initially decreased during treatment, then returned to baseline by 24 months after treatment. Subcutaneous fat area increased from baseline by 6.5% (95% confidence interval [CI] = 2.6% to 10.5%) during treatment and by 21.4% (95% CI?=?15.7% to 27.2%) by 24 months after treatment. Visceral fat area increased from baseline by 4.5% (95% CI = -0.9% to 9.9%) during treatment and by 21.6% (95% CI?=?14.8% to 28.4%) by 24 months after treatment. Variables associated with long-term development of sarcopenia included: baseline sarcopenia (adjusted odds ratio [aOR] = 17.21, 95% CI?=?8.48 to 34.94), older than age 60 years (aOR = 2.93, 95% CI?=?1.46 to 5.88), and weight loss greater than 5% during treatment (aOR = 2.40, 95% CI?=?1.12 to 5.14). Variables associated with long-term visceral fat gain included: weight gain greater than 5% during treatment (aOR = 4.60, 95% CI?=?2.42 to 8.74).DLBCL survivors undergo unfavorable long-term body composition changes. Patients at risk for the long-term development of sarcopenia or visceral obesity can be identified based on clinical risk factors and targeted for lifestyle interventions.

SUBMITTER: Xiao DY

PROVIDER: S-EPMC5241900 | biostudies-other | 2016 Nov

REPOSITORIES: biostudies-other

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Longitudinal Body Composition Changes in Diffuse Large B-cell Lymphoma Survivors: A Retrospective Cohort Study of United States Veterans.

Xiao Daphne Y DY Luo Suhong S O'Brian Katiuscia K Sanfilippo Kristen M KM Ganti Arun A Riedell Peter P Lynch Ryan C RC Liu Weijian W Kahl Brad S BS Cashen Amanda F AF Fehniger Todd A TA Carson Kenneth R KR

Journal of the National Cancer Institute 20160705 11

<h4>Background</h4>Body composition parameters are associated with long-term health outcomes. We assessed longitudinal body composition changes in diffuse large B-cell lymphoma (DLBCL) survivors and identified clinical variables associated with the long-term development of sarcopenia and visceral obesity.<h4>Methods</h4>A retrospective cohort of United States veterans with DLBCL treated with cyclophosphamide, doxorubicin, vincristine, and prednisone, with or without rituximab, was assembled. Mus ...[more]

PMID: 27381623

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Project description:PurposePrimary purpose was to assess changes of bone mineral density (BMD) in diffuse large B cell lymphoma (DLBCL) patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone R-CHOP (like) chemotherapy regimen. Secondary purposes were to assess other body composition features changes and to assess the association of pre-therapy values and their changes over time with survival.Material and methodsPatients selected underwent R-CHOP(like) regimen for DLBCL, and underwent PET-CT before and after treatment. Main clinical data collected included body mass index, date of last follow-up, date of progression, and date of death. From the low-dose CT images, BMD was assessed at the L1 level; the other body composition values, including muscle and fat distribution, were assessed at the L3 level by using a dedicated software. Descriptive statistics were reported as median and interquartile range, or frequencies and percentages. Statistical comparisons of body composition variables between pre- and post-treatment assessments were performed using the Wilcoxon matched pairs signed rank test. Non-normal distribution of variables was tested with the Shapiro-Wilk test. For qualitative variables, the Fisher exact test was used. Log rank test was used to compare survival between different subgroups of the study population defined by specific body composition cutoffs. The significance level was set at p < 0.05.ResultsEighty-two patients were included. The mean follow-up was 37.5 ± 21.4 months. A significant difference was found in mean BMD before and after R-CHOP(like) treatment (p < 0.0001). The same trend was observed for mean skeletal muscle area (SMA) (p = 0.004) and mean skeletal muscle index (SMI) (p = 0.006). No significant association was demonstrated between body composition variables, PFS and OS.ConclusionR-CHOP(like) treatment in DLBCL patients was associated with significant reduction of BMD, SMA and SMI.

Project description:BackgroundWhile residential mobility affects people's health, the dynamic of neighborhood tenure and its associated factors among cancer patients and survivors have not been studied in detail. This cross-sectional study aimed to identify sociodemographic factors associated with neighborhood tenure and relocation after the first cancer diagnosis among U.S. adult cancer survivors and patients.MethodsBased on a nationally representative sample of non-institutionalized civilian adults (≥18 years, n = 185,637) from the 2013-2018 National Health Interview Survey, we compared neighborhood tenure between adults with and without a history of cancer, and identified factors associated with their neighborhood tenure and relocation after the first cancer diagnosis, using propensity score matching, and logistic regression models with survey design incorporated.ResultsAmong adults with cancer (9.0%), 39.6% had a neighborhood tenure ≤10 years (vs. 61.2% among those without cancer), and 25.6% (equivalent to 5.4 million) relocated after their first cancer diagnosis. The odds of having shorter neighborhood tenure was higher among the cancer group in the propensity-matched samples (odds ratio = 1.05; 95% CI: 1.05-1.06; n = 17,259). Among cancer survivors, the odds of neighborhood relocation were negatively associated with increasing age, perceived neighborhood social cohesion, having high school level education, and being married; while positively associated with having family income below the poverty threshold, being uninsured, and living in non-Northeast regions.ConclusionsHigh residential mobility was found among a sizable proportion of adults with a history of cancer, and was associated with multiple socioeconomic factors. Incorporating and addressing modifiable risk factors associated with residential mobility among cancer patients and survivors may offer new intervention opportunities to improve cancer care delivery and reduce cancer disparities.

Dataset Information

Longitudinal Body Composition Changes in Diffuse Large B-cell Lymphoma Survivors: A Retrospective Cohort Study of United States Veterans.

Publications

Longitudinal Body Composition Changes in Diffuse Large B-cell Lymphoma Survivors: A Retrospective Cohort Study of United States Veterans.

Similar Datasets

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