Integration of low muscle mass into the IPS system and its prognostic significance in patients with Hodgkin's lymphoma

Biomark Med. 2022 Feb;16(2):57-67. doi: 10.2217/bmm-2021-0696. Epub 2021 Nov 10.

Abstract

Aim: The aim of this study is to determine whether a novel prognostic score can be obtained by including low muscle mass in the international prognostic score (IPS) system. Materials & Methods: Psoas muscle areas were determined in the PET/CT scans of the patients taken for staging at the time of diagnosis and after two cycles of ABVD. After evaluating the effect of low muscle mass on overall survival, receiver operating characteristic (ROC) analyzes were performed by including it in IPS systems. Results: Overall survival was significantly lower in patients with low muscle mass. Adding low muscle mass to IPS scores increased AUC, sensitivity and specificity. Conclusion: The integration of low muscle mass into the IPS scoring systems increased the success of these systems in predicting a prognosis.

Keywords: Hodgkin's lymphoma; international prognostic score; low muscle mass; psoas muscle index; sarcopenia.

Plain language summary

Lay abstract Hodgkin's lymphoma is a cancer that responds well to standard treatments. However, the cancer recurs 30% of the time. Improved scoring systems could help better predict the outcomes of treatment. The ‘International Prognostic Score’ (IPS) system is an algorithm currently used to predict the possibility of death and treatment complications. In this study, low muscle mass is evaluated as data that could be added to the current scoring system to improve the system's ability to predict outcomes. Data from the scans of patients before and after treatment were used to determine the muscle mass. It was found that survival was significantly lower in patients with low muscle mass. This suggests that this information is highly effective in predicting the outcomes of Hodgkin's lymphoma patients.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols
  • Bleomycin / therapeutic use
  • Dacarbazine / therapeutic use
  • Doxorubicin / therapeutic use
  • Hodgkin Disease* / diagnostic imaging
  • Humans
  • Muscles / pathology
  • Neoplasm Staging
  • Positron Emission Tomography Computed Tomography
  • Prognosis
  • Vinblastine / therapeutic use

Substances

  • Bleomycin
  • Vinblastine
  • Dacarbazine
  • Doxorubicin